Pleurisy, also known as pleuritis, is a condition in which the thin lining around the chest cavity and lungs (the pleura) becomes inflamed. The pleura normally create a smooth surface that reduces friction between the lungs and chest cavity during breathing. When pleurisy occurs, this surface experiences more friction, which results in inflammation and chest pain.

In some cases, fluid can collect between the pleura. This is called pleural effusion. When there is no fluid, the condition is called dry pleurisy.


Usually the first sign of pleurisy is a distinctive chest pain that starts suddenly. The pain can vary from vague discomfort to an intense stabbing pain. Sometimes it is felt only while breathing deeply or coughing, or it can cause continuous pain that gets worse with deep breathing or coughing. Usually the pain is felt in the chest wall over the location of the inflammation, but it may also be felt in the upper abdominal area or in the neck and shoulder or in a combination of these areas.

Because inhaling deeply hurts, a patient with pleurisy tends to breathe rapidly and shallowly. On the side where the pain is, the muscles of the chest move less than those on the other side. If fluid builds up between the layers of the pleura, the chest pain may go away. Large quantities of fluid can make expanding one or both lungs difficult.

Other less common symptoms may include:

  • Fever
  • Cough
  • Shortness of breath
  • Rapid breathing

Causes and Risk Factors

Pleurisy is caused by inflammation of the pleura, two thin sheets of lining that wrap around the chest cavity and lungs. Normally, these two sheets of lining smoothly glide past one another with each breath. When irritation to the pleura occurs, this causes friction during breathing.

Irritation of the pleura can be caused by:

  • A virus
  • Bacteria
  • Cancer
  • Inhaling asbestos
  • The use of certain drugs, such as nitrofurantoin
  • Some types of autoimmune diseases, such as lupus or rheumatoid arthritis


Diagnosis of pleurisy usually begins with a physical exam and a review of the patient’s medical history and symptoms. Because the pain associated with pleurisy is distinctive, it is often easy for the physician to make a diagnosis. Using a stethoscope on a patient with pleurisy, a squeaky, rubbing sound may be heard. Because the pleura are soft tissues, they do not show up on an X-ray, but a buildup of fluid between the pleura may be seen on an X-ray.

Chest x-rays and CT scans are often used to better understand the patient’s condition by providing am image of what is going on inside the lungs and chest. These diagnostic images can show if fluid has begun to build up in the chest or lungs as well as determine if the lungs are fully inflating. Other imaging diagnostic tests that may be used include an ultrasound or electrocardiogram to rule out the possibility of heart disease.

If fluid has begun to build up in the chest or lungs, the physician may take a sample of the fluid to test it and rule out the possibility of cancer.

A biopsy may also be used to rule out the possibility of cancer. To do this, a needle will be used to remove a small sample of the tissue, which will then be examined under a microscope.

A blood test to detect lupus or rheumatoid arthritis may also be performed.


Treatment for pleurisy will depend on what caused the condition. Medications, home remedies, and lifestyle changes may all be used to treat the condition.

Antibiotics may be prescribed for infections caused by bacteria. If a virus causes the pleurisy, no treatment will be given. If the cause is lupus or an autoimmune disease, corticosteroids often quickly cure the pleurisy.

Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, help relieve the chest pain. Codeine and other stronger pain relievers are not advised because they tend to prevent coughing, which is important to keep the lungs from collapsing and developing pneumonia.

Holding a pillow against the part of the chest that hurts while coughing or breathing deeply can be helpful. Wrapping the chest in wide, elastic bandages can help relieve severe pain, but this makes moving the chest during breathing more difficult and increases the risk of a collapsed lung or pneumonia.

The knowledgeable and highly trained staff at the Women's Guild Lung Institute work as a multidisciplinary team to determine the best treatment option for each patient.