Pleurisy
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Pleurisy is a medical condition where there is inflammation of the pleural space.
Aetiology
Viral infection: adenovirus, herpes simplex or flu.
Bacterial infection: tuberculosis (TB), bacterial pneumonia + other bacteria infections.
Fungal infections.
Autoimmune disorders such as lupus, rheumatoid arthritis and sarcoidosis.
Cancer.
Chest trauma.
Pathophysiology
Inflammation of pleural membrane > thickening and swelling of pleura.
Friction caused by rubbing of the pleural membrane against each other > causing discomfort and pain.
Fluid accumulation > impaired lung function as lungs unable to fully expand > reduced oxygen supply to the body.
If not severe = self resolve. If severe > scarring occurs > pleural thickening.
Risk factors
Repeated or frequent infections.
Autoimmune disorders.
Chest trauma.
Smoking.
Lung cancer.
Sign and symptoms
Pleuritic chest pain.
Fever, weight loss, productive cough.
O/E: hyperresonance on percussion (if pneumothorax), dullness on percussion (if pleural effusion), haemoptysis (if PE).
Diagnosis and investigations
Chest x-ray: to rule out pneumothorax / pleural effusion.
ECG + Troponin blood test, as the patient may present with chest pain.
Sepsis screen.
D-dimer: if suspecting PE.
Management
Pain relief: mainly NSAIDs e.g naproxen, ibuprofen.
Treating the underlying cause.
Chest drainage if fluid in pleural space.
Antibiotic treatment.
Oxygen therapy.
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