What Is Pleurisy? Understanding Causes, Types, and Symptoms

Pleurisy, also known as pleuritis, is a medical condition characterized by inflammation of the pleura—the delicate membranes that line the lungs and the inner chest wall. When these membranes become inflamed, they lose their natural smoothness, leading to friction during breathing. This often results in sharp chest pain, especially when inhaling deeply, and may be accompanied by other symptoms such as shortness of breath, dry cough, and sometimes fever.

Common Causes of Pleurisy

The development of pleurisy can stem from a variety of underlying health issues. One of the most frequent causes is viral infection, which often resolves on its own without specific treatment. Bacterial infections, including pneumonia and tuberculosis, are also major contributors. Tuberculous pleurisy, caused by Mycobacterium tuberculosis, remains a significant concern in regions where TB is prevalent.

Bacterial and Viral Forms

Bacterial pleurisy typically occurs when an infection spreads from the lungs into the pleural space, potentially leading to pus accumulation (empyema). In contrast, viral pleurisy is usually milder and often linked to common respiratory viruses like influenza or coxsackievirus. While symptoms may be less severe, proper diagnosis is essential to rule out more serious conditions.

Malignant Pleurisy: A Serious Complication

Another critical form is malignant pleurisy, which arises when cancer—particularly lung cancer or metastatic tumors—spreads to the pleura. This type is often associated with pleural effusion, where excess fluid builds up between the pleural layers, compressing the lungs and causing significant breathing difficulties.

Symptoms and Diagnosis

The hallmark symptom of pleurisy is sharp, stabbing chest pain that worsens with breathing, coughing, or sneezing. Other signs include rapid, shallow breathing, unexplained weight loss (especially in malignant cases), and fatigue. Diagnosing pleurisy involves a combination of physical examination, imaging tests like chest X-rays or CT scans, and sometimes thoracentesis—where fluid is extracted from the pleural space for analysis.

Why Early Detection Matters

Early identification and treatment of pleurisy are crucial to prevent complications such as lung collapse or chronic pleural thickening. Treatment varies depending on the cause: antibiotics for bacterial infections, antivirals if applicable, and in some cases, drainage of excess fluid or even surgery. For those with recurrent or persistent symptoms, ongoing monitoring by a pulmonologist is recommended.

Understanding pleurisy empowers patients to seek timely care and improve outcomes. With proper medical intervention, most people recover fully, especially when the underlying cause is addressed promptly.