Pleura refers to the two-layered membrane surrounding the lungs and rib cage. It protects as well as lubricates the lungs' surface as they breathe in and out. Between these layers is a fluid-filled gap called pleural space that allows smooth sliding. Pleurisy takes places when the membrane layers become inflamed. This condition, which makes breathing, coughing and sneezing very painful, is sometimes linked to pleural effusion, a condition characterized by having excess fluids between the layers membranes.
Medical experts point out that the most common cause of pleurisy is viral infection. But it can also be caused by lung infections like tuberculosis and pneumonia, chest injuries, drug reactions, and medical conditions like pulmonary embolism, cancer, rheumatoid arthritis, liver diseases and systemic lupus erythematosus (lupus).
The foremost symptom is that distinctive pain felt in the chest, which can be described as severe, sharp pain affecting only one side. The pain strikes when a person breathes deeply, coughs, sneezes or talks. It goes away when the person holds his/her breath. For pleurisy that occurs in certain parts of the lungs, the pain also reverberates to the other parts of the body like neck, abdomen and shoulder. At times, rapid shallow breathing is present as response to the pain. If there is fever, it could indicate a lung infection and it's a must to call up the doctor immediately.
The doctor will need to use a stethoscope to listen to your chest while you breathe. If he/she finds that there is an abrasive or raspy sound coming from the two layers of the pleura rubbing against each other, he/she can confirm the diagnosis. That unique sound is usually heard at the last part of your inhalation and onset of the exhalation. Your doctor may perform additional examinations such as X-ray, CT scan and ultrasound scan to find out how the pleural space looks like. Only in rare cases would a biopsy be needed. This is done to analyze the tissue as well as determine the cause of the condition. Biopsy can be done by inserting a biopsy needle into the skin, by making a small cut in the chest wall or by using a thoracoscope. This is a video-assisted device used for viewing the chest cavity.
Once the doctor identifies the underlying cause of your condition, the doctor will formulate a treatment plan that may start with administration of antibiotics to curb the infection. The doctor may also prescribe pain medications and anti-inflammatory drugs. The painful coughing can be resolved by taking in a codeine-based cough syrup. If the underlying cause is pleural effusion, the doctor will insert a tube into your chest to drain the excess amount of fluids. This procedure requires hospital stay.