Lung Disease & Respiratory Health Center

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See a picture of pleural effusion .

Pleural effusion may occur without pleurisy in other conditions, such as heart failure or liver or kidney disease.

How is pleurisy diagnosed?

Many different health problems can lead to pleurisy, so your doctor will look for what is causing your inflammation. He or she will use a physical exam and a chest X-ray to look for signs of conditions that may cause pleuritic chest pain, such as:

• Viral infections.
• Chest muscle strain.
• Rib fracture.
• Blood clots in the blood vessels of the lung (pulmonary embolism).
• Inflammation around the heart (pericarditis).
• Pneumonia.
• Tuberculosis.
• Fluid in the pleura (pleural effusion).

If your doctor thinks your pleurisy may be caused by an autoimmune disease such as lupus or rheumatoid arthritis, he or she may do blood tests.

If you have pleural effusion, your doctor may use a needle to remove some of the fluid from the pleura. This procedure is called thoracentesis. The fluid is then studied, to help your doctor find out the cause of the effusion.

See pictures of pleural effusion and thoracentesis .

How is pleurisy treated?

The treatment for pleurisy depends on the cause. For example, if a bacterial infection is the cause, you will probably need an antibiotic. If a pulmonary embolism is present, you may get medicine to dissolve the clot or to prevent future blood clots (anticoagulants).

For most cases of pain caused by pleurisy, your doctor will suggest that you use aspirin, ibuprofen, or another nonsteroidal anti-inflammatory drug (NSAID). Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome. If you have severe pain, you may need prescription cough or pain medicine. You may also be able to relieve pain by lying on the painful side or pressing a pillow against it.

If you have pleural effusion, you may need to have the fluid drained through a tube that the doctor inserts in your chest.

In some cases of pleural effusion, you may need pleurodesis. During this procedure, a medicine is put into your chest cavity, which triggers an inflammatory reaction over the surface of the lung and inside the chest cavity. This causes the surface of the lung to stick to the surface of the chest cavity, which prevents more fluid from building up or reduces the amount of fluid.