Pleurisy

The pleural membrane which surrounds each lung normally has a thin layer of lubricating fluid in between its two layers (the pleural cavity) which allows the membranes to slide across each other smoothly as the lungs expand and relax. In pleurisy, the pleura becomes inflamed and congested, losing its smooth surface. In primary pleurisy the inflammation may arise from injury, exposure to cold, or infection. Secondary pleurisy is due to spread of disease, such as pneumonia, tuberculosis, bronchitis or pulmonary abscess, from the lungs.

Symptoms

In dry pleurisy a coating of the protein fibrin, varying in thickness from a thin film to a thick pasty coating, forms between the layers of membrane. The inflamed membranes then rub together, causing a sharp chest pain as the rib-cage moves during breathing. In pleurisy with effusion, or wet pleurisy, the two layers become separated by fluid and there is no pain, although there may be shortness of breath as the lung is compressed by the fluid. A sample of this fluid can he taken and used for diagnosis.

Treatment

Treatment usually consists of antibiotics and bed-rest. If the amount of fluid is large and makes breathing difficult, even causing the lung to collapse, it can be drained.