screening for pleurisy

Overview

Pleurisy is a condition where the pleura — the thin, double-layered membrane that lines the outside of your lungs and the inside of your chest — becomes swollen and inflamed. This can cause sharp chest pain, especially when you breathe in, cough, or move. It is sometimes called pleuritis.

Pleurisy used to be more common than it is today. Thanks to better treatment of chest infections, it is now less frequent, but it can still happen at any age.

Anyone can develop pleurisy. You are more likely to get it if you have a lung infection, an autoimmune condition like lupus, a recent chest injury, or you have had surgery near your chest.

Symptoms

Common symptoms

• Sharp, stabbing chest pain when you breathe in or cough
• Shortness of breath
• Dry cough
• Fever and chills
• Pain that spreads to your shoulder or back

Symptoms in children

• Chest pain
• Fast or difficult breathing
• Fever
• Being unusually fussy or tired
• A dry cough

Symptoms in older adults

• Milder chest pain or simply a feeling of heaviness in the chest
• Shortness of breath with activity
• Confusion or unusual tiredness
• Low fever or no fever

Causes

Main causes

• Viral infections, such as the flu or a cold
• Bacterial infections, like pneumonia or tuberculosis
• Autoimmune conditions, such as lupus or rheumatoid arthritis
• A blood clot in the lung (pulmonary embolism)
• Chest injury or rib fracture
• Sometimes, after heart or lung surgery

Risk factors

• Having a lung infection or pneumonia
• Having an autoimmune disease
• A recent chest injury or surgery
• Exposure to asbestos
• Smoking or being around smoke

When to see a doctor

See a doctor urgently if:

• If you have chest pain that makes it hard to breathe deeply
• If you have a fever with chest pain
• If you are breathless even at rest

Book a routine appointment if:

• If you have a lingering cough or chest discomfort that lasts more than a few days
• If you have had pleurisy before and the pain is returning

Diagnosis

A doctor will ask about your symptoms and listen to your chest with a stethoscope. A specific grating sound called a 'friction rub' can point to pleurisy. They may then order tests to find the cause and check how your lungs are working.

Tests that may be done

• Chest X-ray to see the lungs and the space between the lungs and chest wall
• Blood tests to look for infection or inflammation
• Ultrasound or CT scan to get a clearer picture of the chest
• Pleural fluid sampling — a small amount of fluid around the lungs is taken with a needle to be examined

What to expect at your appointment

The tests are usually quick and painless. If fluid needs to be sampled, the area is numbed first. You will likely get results the same day or within a few days, depending on the test.

Treatment

Treatment for pleurisy depends on what is causing it. The main goals are to reduce pain and inflammation, treat any underlying infection, and make sure fluid does not build up around the lungs.

Self-care at home

• Rest until the pain starts to ease
• Take over-the-counter pain relief medication as recommended by your pharmacist or doctor
• Apply a warm compress or warm cloth to your chest
• Try slow, gentle breathing exercises once the pain is controlled
• Avoid smoking and smoky places

Medical treatments

Depending on the cause, doctors may prescribe anti-inflammatory medicines to reduce swelling, antibiotics for bacterial infections, or medicines to treat an autoimmune condition. If a large amount of fluid has built up around the lungs, a doctor may drain it with a needle or a small tube. Always follow your doctor's advice and ask questions if anything is unclear.

When is surgery considered?

Surgery is rarely needed for pleurisy itself. It may be considered if fluid collections need to be removed repeatedly, if a complication like an abscess develops, or if the underlying cause — such as a blood clot or tumour — requires surgical treatment. Your specialist will explain the options if surgery is a possibility.

Living with this condition

Recovery from pleurisy can take anywhere from a few days to a few weeks, depending on the cause. Give yourself time to rest, and gradually resume daily activities as your pain and breathing improve.

Lifestyle tips

• Stop smoking if you smoke, and avoid second-hand smoke
• Take any prescribed medicines exactly as your doctor advises
• Stay up to date with vaccines, including flu and pneumonia vaccines if recommended
• Attend follow-up appointments so your doctor can monitor your progress

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and fluids to support healing. Do light activities like walking as your energy allows, but avoid heavy exercise or strain until your doctor says it is safe.

Mental health and emotional wellbeing

Persistent chest pain and breathlessness can be frightening and may trigger anxiety. It is normal to feel worried. If low mood or anxiety is affecting your daily life, talk to your doctor or someone you trust. If you ever feel hopeless or have thoughts of harming yourself, reach out to a crisis helpline or your local emergency number right away.

Prevention

Pleurisy cannot always be prevented, but you can lower your risk by treating respiratory infections early, managing any underlying conditions, avoiding smoking, and protecting your chest from injury.

Vaccines

Getting vaccinated against flu and pneumococcal pneumonia can help prevent the infections that sometimes lead to pleurisy. Ask your doctor or pharmacist which vaccines are recommended for you.

Screening programmes

There is no routine screening for pleurisy. Screening tests are for people without symptoms. If you notice symptoms such as chest pain with breathing, coughing, or fever, see a doctor for a proper evaluation. Your doctor will decide which tests are needed to diagnose the cause.

Complications

If left untreated

• A build-up of fluid around the lungs (pleural effusion), which can make breathing harder
• A collapsed lung if air escapes into the chest cavity
• Scar tissue forming on the pleura, which may restrict breathing over time
• Chronic pain or thickened pleura that requires long-term management

Long-term outlook

The outlook for pleurisy is usually very good. Once the underlying cause is treated, most people recover fully and return to their normal activities. Even when complications occur, doctors have effective ways to manage them. Your own outcome depends on the cause, so staying in close contact with your healthcare team is the best way to ensure a smooth recovery.

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