Pleurisy

Pleurisy is inflammation of your pleura. It's also called 'pleuritis'.

Your pleura is made up of 2 pleural membranes that cover:

• the outside of your lungs
• the inside of your chest wall

The space between your 2 pleural membranes contains a small amount of fluid called pleural fluid. This fluid helps your lungs and chest wall to move smoothly during breathing.

In people with pleurisy, the pleura become rough or irritated and rub against each other, which is painful.

Pleurisy causes chest pain, usually on one side. The pain is often sharp and stabbing. It tends to get worse with deep breathing and coughing. You may also feel pain in your back or shoulders.

Other symptoms may include:

• shortness of breath or rapid breathing
• cough
• fever
• tiredness

Pleurisy is often caused by a chest infection, such as pneumonia.

Chest infections can be caused by a viral infection (such as influenza) or a bacterial infection.

Pleurisy can also be caused by:

• a pulmonary embolism (a blood clot in the lungs)
• a pneumothorax (air leaking into the pleural space)
• autoimmune diseases, such as lupus, rheumatoid arthritis or Sjogren syndrome
• a chest injury
• a reaction to a medicine

Other causes of pleurisy are:

• lung inflammation related to asbestos exposure
• tuberculosis
• lung cancer
• mesothelioma (a type of cancer caused by exposure to asbestos)

Your doctor will ask about your symptoms and your health in general. They will examine you and listen to your chest with a stethoscope.

Your doctor may also order some tests, including:

• blood tests
• an x-ray, CT scan or ultrasound scan of your chest
• a sputum test (tests a sample of mucus that you cough up)

Your doctor may refer you to a respiratory specialist (doctor who specialises in lung and breathing conditions). Further tests may be recommended, including:

• a procedure to test a sample of your pleural fluid
• a biopsy of your pleura

Treatment depends on the underlying cause of your pleurisy. Some people may need treatment in hospital.

You may be treated with pain-relief medicines, such as:

• anti-inflammatory medicines (NSAIDs)
• stronger pain relievers

If you have a bacterial infection, your doctor will prescribe antibiotics.

There are some things you can do to prevent conditions that can lead to pleurisy:

• Get vaccinated against common infections, such as influenza (the flu), COVID-19 and pneumococcal disease, to help prevent chest infections.
• Avoid exposure to asbestos.
• Quit smoking and vaping and limit your exposure to passive smoke to keep your lungs healthy and reduce your risk of lung cancer.

Some people with pleurisy get a pleural effusion. This is when too much fluid builds up between the linings of the lung and chest wall.

A pleural effusion can cause compression of the lungs, leading to breathing problems.

A pleural effusion can also become infected and lead to a build-up of pus, called an empyema.

Lung Foundation Australia has information and support for people with lung conditions and their carers. You can call Lung Foundation Australia on 1800 654 301.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.