Pleurisy

Question 1

What are the signs and symptoms of Pleurisy?

Answer 1

Signs and symptoms:
* Major pain on inhalation and exhalation, coughing or sneezing
* Cough and fever in some cases
* Dyspnoea from guarding due to painful breathing

Can accompany:
* Pleural effusion
* Empyema (pus in the pleural cavity)
* Collapsed lung

Question 2

What causes Pleurisy?

Answer 2

It’s more of a phenomenon than a condition in itself, when the plural membranes are inflamed

Question 3

What is the pathophysiology of Pleurisy?

Answer 3

Peripheral inflammation of the tissues of the lungs, due to the aetiological
causes noted (eg bacterial, viral, fungal inflection, TB, rheumatoid arthritis or more) .

The inflammation may then extend into the pleural cavity and involve visceral and
parietal pleura. The intercostal innervation of the parietal pleura causes the painful presentation of pleurisy.

If you listen to the chest there will be a plueral rub instead of nice breath sounds.

Question 4

What diagnotic tests and treatments are usual for Pleurisy?

Answer 4

Diagnosis
After case history which will uncover pleural rub and reduced breath sounds on auscultation, key diagnostic tests include:
* Chest X-ray, possible CT scan and ultrasound
* Blood tests to uncover initial cause, tissue biopsy

Conventional treatments tend to involve:
* Pain relief, particularly non-steroidal anti-inflammatories
* Antibiotics if underlying cause bacterial