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An inflammation of the pleura, which is the thin, transparent membrane which covers the lungs and lines the inside of the chest walls, is known a pleurisy. This occurs when the pleura is irritated by a virus or bacteria that results in inflammation. In some cases pleural effusion occurs causing an abnormal collection of fluids to accumulate in the pleural space which can create an even more dangerous situation. When fluid does not form this condition is known as dry pleurisy. Once the inflammation has subsided the pleura may go back to normal. But in some cases adhesions form causing the pleural layers to stick together.
In most cases pleurisy is caused by a lung infection such as pneumonia or a viral infection such as pleurodynia. Less common causes may include lung cancer, pulmonary embolism or rheumatoid arthritis. The symptoms include a sharp chest pain that will move to the tip of the shoulder on the side that is affected. Even though the pain will be continuous it will be much worse when breathing or coughing. In some cases the pain is felt in the abdomen or neck and breathing will be shallow. When large amounts of fluids accumulate there may be additional respiratory distress.
Pain from this condition is caused when the two inflamed membranes rub across each other. Although the treatment of pleurisy will depend on the actual cause a doctor can usually make a diagnose based on the pain and by listening to the chest with a stethoscope. In many cases the doctor may hear a squeaky rubbing sound that is known as a pleural rub. An x-ray may be given and even though pleurisy will not show on an x-ray evidence of a rib fracture, lung disease or a collection of fluid in the pleural space may be revealed. Once the diagnosis has been made the cause of the pleurisy will be treated. When a bacterial infection is found the patient will be treated with antibiotics. If a viral infection is found no treatment is needed but if the cause is related to an autoimmune disease treatment is needed to resolve the condition.
In most cases the patient will be given acetaminophen or ibuprofen which will help relieve the chest pain. Stronger pain relievers such as codeine or other narcotics tend to suppress coughing which is not recommended since this and deep breathing may prevent pneumonia. Patients are usually encouraged to breath deeply once it becomes less painful for them to do so. This is easier to accomplish with a pillow pressed over the affected area.
Under normal circumstances there is a thin layer of fluid that separates the two layers of the pleura. There are many reasons that an excessive amount of fluid may accumulate some of which include heart failure, pneumonia and cirrhosis of the liver. In some cases blood, pus or high cholesterol fluids may accumulate as well. Blood in the pleural space can be caused by a chest injury, impaired blood clotting or an aortic aneurysm. Pus accumulations are usually cause by pneumonia, lung abscess, chest wounds or surgery or an abscess in the abdomen. High cholesterol fluid is usually the result of a pleural effusion that has been present for some time and caused by such conditions as rheumatoid arthritis or tuberculosis. In some cases the fluids can be drained with the use of a long needle. Pus accumulations require intravenous antibiotics as well as drainage.
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