Pleurisy or pleuritis is inflammation of the lining of the lung organ or pleura . This condition causes the sufferer to feel a stabbing chest pain, especially when breathing.
The pleura is a thin membrane that covers the lungs and the inner chest wall. The pleura consists of two layers that play a role in keeping the lungs from rubbing against the walls of the chest cavity.
Between the two layers of the lungs, there is pleural fluid that functions as a lubricant and helps reduce friction when breathing.
When inflammation occurs, the pleura will swell and cause breathing problems. Pleuritis or pleural inflammation is more prone to be experienced by smokers.
Causes of Pleurisy
Pleuritis occurs when the pleura is inflamed and irritated. Inflammation makes the pleura swell and the pleural fluid becomes sticky. This condition can cause chest pain every time the two layers of the pleura rub together, that is when the lungs expand (inhale).
One of the causes of pleuritis is infection, both viral , bacterial, and fungal infections, such as influenza virus or TB bacteria . In addition to infection, pleuritis or pleurisy can also be caused by:
- Autoimmune diseases , such as rheumatoid arthritis and lupus
- Pulmonary organ disorders, such as pulmonary embolism
- Lung cancer
- Injury to the ribs
- Hereditary diseases, such as sickle cell anemia
Symptoms of Pleurisy
The main symptom of pleurisy is severe pain that feels sharp and stabbing in the chest, especially when breathing. The pain in the left or right chest will get worse when sneezing, coughing, laughing or moving, but can subside when holding your breath or pressing on the chest area.
In addition to chest pain, other symptoms that can be experienced by peluritis sufferers are:
- Fever
- Shivering
- Loss of appetite
- Headache
- Joint and muscle pain
- Shoulder and back pain
- Dry cough
- Shortness of breath
When should you go to the doctor?
See a doctor immediately if you experience chest pain. In addition to pleurisy, chest pain can occur as a result of a fatal heart attack .
In addition, immediately consult a doctor if the following symptoms appear:
- High fever up to 40 o C
- Cough accompanied by thick yellow or green sputum
- Swelling in the arms or legs
- Weight loss drastically
- Coughing up blood
- Difficulty breathing
Diagnosis of Pleurisy
As an initial step, the doctor will ask about the patient's symptoms and health history. After that, the doctor will use a stethoscope to check the sound inside the lung organ.
To see if there is inflammation in the pleura or lungs, the doctor will scan the lungs with a chest X - ray, chest CT scan, or chest ultrasound. The examination can also detect the accumulation of fluid in the space between the pleura.
When pleural fluid accumulates, the doctor will perform a thoracocentesis or pleural puncture, which is the collection of a sample of lung fluid with a special needle, to be examined in the laboratory.
In addition to scanning, the doctor will also perform other examinations to support the diagnosis, including:
- Blood tests, to detect signs of infection or other diseases underlying pleurisy, such as rheumatoid arthritis and lupus
- Electrocardiogram (EKG) , to check if chest pain is caused by heart problems
- Thoracoscopy or pleuroscopy, to check the condition of the chest cavity through a small tube with a camera.
- Biopsy (tissue sampling) of the pleura, which can be done during a thoracoscopy procedure
Treatment of Pleurisy
Treatment of pleurisy depends on the underlying cause. The purpose of treatment is to overcome inflammation, relieve pain, and treat the cause of pleurisy.
The following are some types of medicine that can be used to deal with pleuritis:
- Antibiotics, such as cephalosporins , to treat pleurisy caused by bacterial infections
- Antifungals, such as fluconazole , to treat fungal infections that cause pleurisy
- Nonsteroidal anti- inflammatory drugs , such as ibuprofen, to overcome inflammation and relieve chest pain
- Blood thinners or anticoagulants , such as warfarin and heparin, to treat pleurisy caused by pulmonary embolism
- Codeine , to relieve cough
- Immunosuppressant drugs , such as prednisone and ciclosporin, to deal with pleurisy caused by autoimmune diseases, such as rheumatoid arthritis .
Pleurisy caused by a virus can heal in a few days with enough rest that antiviral drugs are not needed.
Meanwhile, surgery can be performed on pleurisy caused by lung cancer. The operation aims to remove part or all of the lung organ. In addition to surgery, radiotherapy or chemotherapy can also be done to deal with lung cancer.
Complications of Pleurisy
If not treated immediately, pleuritis can cause the accumulation of fluid in the space between the pleura ( pleural effusion ). This complication is often experienced by patients with pleurisy due to bacterial infection or pulmonary embolism.
Pleural effusion is characterized by worsening shortness of breath, as well as blue mouth and fingertips due to lack of oxygen in the body ( cyanosis ).
Pleural effusion can recover if the condition that caused the pleurisy is successfully treated. However, if the treatment of pleurisy cannot overcome the pleural effusion that occurs, then the doctor will perform an operation procedure to remove fluid from the pleural cavity.
Prevention of Pleurisy
Pleurisy can be prevented by avoiding the cause. For example, pleurisy due to pneumococcal bacterial infection can be prevented through pneumococcal vaccination ( PCV vaccine ).
Pleuritis is also prone to be experienced by a smoker. Therefore, not smoking is one of the efforts to prevent pleurisy. Not smoking can also prevent lung cancer that can cause pleurisy.