home monitoring for pleurisy

Overview

Pleurisy is inflammation of the pleura, the thin lining that covers your lungs and the inside of your chest wall. It causes a sharp, stabbing chest pain that gets worse when you breathe deeply, cough, or sneeze.

Pleurisy is a fairly common condition, especially after a respiratory infection.

It can affect people of all ages, but it is most often seen in young adults and those with weakened immune systems.

Symptoms

Common symptoms

• Sharp chest pain that worsens when you breathe in, cough, or move
• Shortness of breath because the pain makes you take shallow breaths
• Dry cough
• Fever and chills (if infection is present)

Symptoms in children

• Fussiness or irritability
• Rapid, shallow breathing
• Refusing to eat or drink
• Fever

Symptoms in older adults

• Chest pain may be less sharp and more like a dull ache
• Confusion or feeling very tired
• Shortness of breath with little activity

Causes

Main causes

• Viral infections like flu or cold
• Bacterial infections such as pneumonia or tuberculosis
• Autoimmune conditions like lupus or rheumatoid arthritis
• Chest injury or surgery
• Blood clot in the lung (pulmonary embolism)

Risk factors

• Having a recent respiratory infection
• Having a weakened immune system (from illness or medication)
• Smoking
• Having an autoimmune disease

When to see a doctor

See a doctor urgently if:

• You have trouble breathing or severe chest pain
• Your fever is high and does not come down
• You cough up blood or yellow/green mucus

Book a routine appointment if:

• You have chest pain lasting more than a few days without other symptoms

Diagnosis

A doctor will listen to your chest with a stethoscope for a scratchy sound called a pleural rub, which is a sign of pleurisy. They will also ask about your symptoms and medical history.

Tests that may be done

• Chest X-ray to look for fluid, infection, or other causes
• Blood tests to check for infection or inflammation
• CT scan for more detailed images
• A sample of fluid from the pleural space (thoracentesis) if needed

What to expect at your appointment

Most tests are quick and painless. If you need a fluid sample, the doctor will numb the area first. You will be asked to sit still and breathe normally. Results often come back within a few days.

Treatment

Treatment focuses on the underlying cause and relieving the pain. With proper care, most people recover fully.

Self-care at home

• Get plenty of rest to let your body heal
• Take over-the-counter pain relief medicine (ask your pharmacist which one is right for you)
• Apply a warm compress or heating pad to the outside of your chest to ease muscle tension
• Sleep in a propped-up position to make breathing easier
• Breathe gently and avoid deep breaths that trigger pain

Medical treatments

If an infection is the cause, your doctor may prescribe antibiotics (for bacteria) or antiviral medicine (for viruses). Anti-inflammatory medicines can help reduce swelling and pain. Sometimes fluid needs to be drained with a needle or tube if there is a lot of buildup.

When is surgery considered?

Surgery is rarely needed. It may be considered if there is a large collection of pus (empyema) that cannot be drained with a needle, or if the pleura is scarred and preventing lung expansion.

Living with this condition

While you recover, keep track of your symptoms – note when pain is worse and how your breathing feels. Avoid activities that cause pain, like heavy lifting or intense exercise. Let your body guide your activity level.

Lifestyle tips

• Do not smoke or vape – smoking irritates the lungs and delays healing
• Stay well hydrated with water and warm fluids
• Avoid exposure to secondhand smoke and air pollution

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and protein to support your immune system. Gentle movement like slow walking is fine, but stop if it causes pain. As you heal, you can slowly return to normal exercise.

Mental health and emotional wellbeing

Persistent chest pain can make you feel anxious or worried. It is normal to feel stressed. Try deep breathing exercises (when not painful), relaxation techniques, or talking to a friend or counselor.

Prevention

You cannot always prevent pleurisy, but you can lower your risk by avoiding respiratory infections and taking care of your lungs.

Vaccines

Getting the flu vaccine and pneumonia vaccine can help prevent infections that sometimes lead to pleurisy.

Screening programmes

There is no routine screening for pleurisy. See your doctor if you have symptoms.

Complications

If left untreated

• Pleural effusion – fluid build-up between the lung and chest wall that can make breathing very hard
• Empyema – a pocket of pus that may need to be drained
• Scarring of the pleura (pleural thickening) that can reduce lung function

Long-term outlook

With proper treatment, almost all people with pleurisy recover fully without long-term problems. Serious complications are rare. Healing can take a few days to a few weeks, depending on the cause.

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