Pleurisy

What is pleurisy?

Pleurisy (“PLUR-uh-see”) happens when the lining (tissue layer) around your lungs or the lining on the inside wall of your chest swells up. This makes the two layers rub against each other, causing sharp pains. Pleurisy is also called pleuritis.

Your lungs and the inside of your chest are each lined with a thin layer called pleura. The space between them (pleural space) is filled with fluid that allows them to slide smoothly along each other when you breathe, like oil in a machine. When one or both layers become swollen (inflamed), they rub painfully against each other instead.

How do I know if I have pleurisy?

Pleurisy causes chest pain that’s sharp and stabbing. There are lots of different conditions that can cause chest pain, and many of them need immediate medical attention. The only way to know for sure if you have pleurisy is to get checked by your healthcare provider.

How do you get pleurisy?

You can get pleurisy when inflammation from your lungs — caused by a virus, bacteria or other illness — moves into your pleurae, causing them to swell up and rub against each other. This can also happen if there’s a blockage (like a tumor) or damage to your lung.

Who does pleurisy affect?

Anyone can get pleurisy, but you’re at a higher risk if you:

• Are over 65.
• Have a condition that causes inflammation in your body (like an autoimmune disease).
• Take medications that cause inflammation in your body.
• Have tumors or scarring in your lungs.

How serious is pleurisy?

Pleurisy can be mild or very serious. It depends on what’s causing it and whether you have additional complications.

What are the symptoms of pleurisy?

The main symptom of pleurisy is chest pain (pleuritic pain) that feels sharp, stabbing or knife-like, coming from one specific place. It’s worse when you breathe deeply or cough and sometimes spreads to your shoulder or back. You’ll probably find yourself breathing carefully to avoid the pain.

You might also have:

• Shortness of breath.
• Cough.
• Fever.
• Extreme tiredness (fatigue).

What causes pleurisy?

If you’re otherwise healthy, you’re most likely to get pleurisy from a virus (like the flu), bacteria or other infection in your lungs. Infections can cause inflammation in your pleurae, which gives you chest pain.

You can also get pleurisy from:

• Autoimmune diseases such as lupus, rheumatoid arthritis or familial Mediterranean fever (FMF).
• Lung or pleural disease such as lung cancer, mesothelioma, tuberculosis or asbestosis.
• Chest surgery or trauma.
• A blood clot in your lung (pulmonary embolism).
• Inflammatory bowel disease.
• Sickle cell disease.
• Certain medications, including hydralazine, isoniazid and procainamide.

Is pleurisy contagious?

While the viruses and bacteria that can cause pleurisy are contagious, pleurisy itself is not.

Is pleurisy linked to COVID-19?

Being sick with a virus can make you more likely to get pleurisy. However, pleurisy isn’t a common symptom of COVID-19.

How is pleurisy diagnosed?

To diagnose pleurisy, your healthcare provider will listen to your lungs and ask you about your health history. They’ll ask you questions about your pain, like where it hurts, what it feels like and if anything makes it worse. They may want you to get imaging or other tests done.

What tests will be done to diagnose pleurisy?

Your healthcare provider uses tests to diagnose pleurisy and figure out the underlying cause. Possible tests include:

• Blood tests. Your provider looks at a sample of your blood for signs of infection or autoimmune disorders.
• Electrocardiogram (EKG or ECG). Your provider may use small electrodes on your body to see how well your heart is working. This is to make sure a heart problem isn’t causing your chest pain.
• Imaging tests. Your provider takes pictures of your lungs using X-rays, CT scans and ultrasounds to help them figure out what’s causing your pain.
• Fluid testing (thoracentesis). Your provider inserts a small needle into the area around your lungs and removes fluid. They examine the fluid for signs of infection or clues to other causes of pleurisy.
• Thoracoscopy. Your provider uses a small, lighted tube with a camera to look inside your lungs and find any problems.

Will a chest X-ray show pleurisy?

Chest X-rays can’t show pleurisy directly, but they can give your provider clues about what might be causing your symptoms, like fluid around the lungs (pleural effusion) or an infection (pneumonia).

How is pleurisy treated?

Treatment for pleurisy depends on what’s causing it. Your healthcare provider will work with you to treat the underlying cause. They can also help you manage your pain in the meantime.

Your treatment options might include:

• Medication for infection. If your pleurisy is caused by an infection, your healthcare provider may prescribe antibiotics or antifungal medications.
• Medication for symptom relief. You provider may suggest nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids for your pain.
• Fluid draining. Your provider may remove fluid from your lungs (thoracentesis) to help ease your pain.

How can I reduce my risk of pleurisy?

You can’t know if an injury or illness will lead to pleurisy, but you can reduce your risk by:

• Not smoking.
• Treating underlying conditions, such as autoimmune or lung diseases.
• Washing your hands to help prevent bacterial or viral infection.

What can I expect if I have pleurisy?

Your outlook for pleurisy depends on what’s causing it. If your pleurisy is caused by infection, it should go away as you get better. If it’s caused by an ongoing illness like cancer or an autoimmune disease, you may always have some risk of pleurisy coming back.

Very rarely, pleurisy has life-threatening complications.

Can pleurisy go away on its own?

If pleurisy is caused by a virus, it can go away on its own as you get over being sick. More serious underlying causes (such as cancer or other illnesses) need to be treated before pleurisy will get better.

Are there any complications of pleurisy?

You may have other conditions along with pleurisy, including:

• Partial lung collapse (atelectasis).
• Excess fluid around your lungs (pleural effusion).
• Pus collecting around your lungs (empyema).

Can you get pleurisy more than once?

Yes. If you have an illness that puts you at risk for pleural inflammation, you might get pleurisy more than once.

How do I take care of myself if I’m at risk for pleurisy?

If you have a health condition that puts you at risk for pleurisy, talk to your healthcare provider about your concerns. Together, you can make a plan to reduce your risk. Be sure to ask what you can do at home and when you should get help for your pain.

When should I see my healthcare provider or go to the ER?

Chest pain is a symptom of many conditions, some of them life-threatening. If you’re having unexplained chest pain, go to the nearest ER.

What questions should I ask my healthcare provider?

If you have pleurisy, you may want to ask your healthcare provider:

• What’s causing my pleurisy?
• Should I consider genetic testing?
• If medicine caused my pleurisy, should I stop or change my medicine?
• Am I at higher risk for other lung conditions?
• What can I do at home to relieve pain?
• What signs of complications should I look out for?
• Am I likely to get pleurisy again?

A note from Cleveland Clinic

The sharp, stabbing pains of pleurisy can be unbearable. You don’t have to just put up with the pain. While you treat the underlying cause of pleurisy, work with your provider to find pain relief that works for you.

Chest pain can have serious causes other than pleurisy. If you’re having unexplained chest pain, go to your nearest ER.