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RespiratoryICD-10: R09.1Common complication of respiratory infections; exact prevalence varies by cause

Pleurisy

Also known as: Pleuritis

Pleurisy is an inflammation of the pleura — the two-layered membrane surrounding the lungs and lining the chest cavity. When inflamed, the pleural surfaces rub against each other during breathing, causing sharp, stabbing chest pain that worsens with inhalation. Pleurisy can be caused by infections, autoimmune diseases, or pulmonary embolism, and treatment targets the underlying cause.

Symptoms

Sharp, stabbing chest pain that worsens with breathing, coughing, or sneezing
Shortness of breath (to avoid the pain of deep breathing)
Cough
Fever and chills (if caused by infection)
Shoulder pain
Rapid, shallow breathing

Causes

  • Viral infections (most common cause, including influenza and COVID-19)
  • Bacterial pneumonia
  • Pulmonary embolism
  • Autoimmune conditions (lupus, rheumatoid arthritis)
  • Chest trauma or rib fracture

Risk Factors

  • Recent respiratory infection
  • Autoimmune diseases
  • Pulmonary embolism risk factors (immobility, surgery, cancer)
  • Lung cancer or mesothelioma
  • Chest trauma

Diagnosis

  • Physical examination (pleural friction rub on auscultation)
  • Chest X-ray to check for pleural effusion or underlying lung disease
  • CT scan to evaluate for pulmonary embolism or masses
  • Blood tests (CBC, inflammatory markers, D-dimer, autoimmune panels)
  • Thoracentesis if pleural effusion is present (fluid analysis)

Treatment

  • NSAIDs (ibuprofen, indomethacin) for pain and inflammation
  • Antibiotics if bacterial infection is the cause
  • Anticoagulants if pulmonary embolism is identified
  • Treatment of the underlying autoimmune condition
  • Thoracentesis to drain large pleural effusions causing breathing difficulty

Prevention

  • Prompt treatment of respiratory infections
  • Vaccination against influenza and pneumococcal disease
  • Early diagnosis and management of autoimmune conditions
  • DVT prevention measures to reduce pulmonary embolism risk

When to See a Doctor

  • Sharp chest pain that worsens with breathing
  • Chest pain with shortness of breath or fever
  • Chest pain following recent surgery, travel, or prolonged bed rest (PE concern)
  • Persistent chest pain that does not improve with OTC pain relievers

Frequently Asked Questions

Related Conditions

Pneumonia

Respiratory

Pulmonary Embolism

Cardiovascular

Lupus

Autoimmune

Pericarditis

Cardiovascular

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.