Chest Wall Infections

The chest wall, sometimes called the thoracic wall, protects the heart, liver, lungs and other vital organs. The wall is made up of the ribs, the sternum and cartilage. Together these pieces form a protective cavity within the abdomen.

The chest wall can become infected by bacteria or viruses. In rare cases, fungal infections can also happen. Infections of the chest wall can often lead to inflammation and pain in the affected area.

Types of chest wall infections include:

  • Pleurisy — infection of the thin membranes (pleura) of the chest wall
  • Costochondritis — inflammation of the cartilage that connects the upper ribs to the sternum
  • Empyema — fluid that builds up between the pleura and the inner lining of the chest wall


The most common symptom related to a chest wall infection is chest pain. This is often due to the inflammation caused by the infection and may become more severe with activity. Other common symptoms include:

  • Tenderness
  • Swelling
  • Difficulty taking a deep breath
  • Pain in the shoulders or back
  • Headaches
  • Joint pain
  • Dry cough
  • Fever

Causes and Risk Factors

Chest wall infections can occur in both men and women, and in patients of any age. The condition is caused by a bacteria or virus, and in rare cases, a fungus, that has invaded the affected area.

Patients with a compromised immune system are at an increased risk of developing a chest wall infection. Common conditions that may increase a patient’s risk include:


Diagnosis of a chest wall infection usually starts with a physical exam and a review of the patient’s medical history and symptoms.

Imaging diagnostic tests such as a chest x-rays look at the soft tissue and bones in the body to find out if there is inflammation in the chest wall. These images can also help diagnose other related conditions, such as pneumonia.

Blood tests may be done to find out if a bacterial or viral infection is causing the condition.

Other tests such as a bronchoscopy may be used to look at the tissue within the chest wall or at the airway to study inflammation or other signs of infection.


Treatment for chest wall infections will often focus on fighting the infection that is causing the symptoms. Antibiotic medications to help fight the infection and reduce inflammation often are prescribed.

Many anti-inflammatory medications such as ibuprofen are available over the counter without a prescription and can provide relief for many patients who are experiencing pain due to inflammation.

Prescription painkillers may be provided to help reduce severe pain. Other prescription medications that can help control pain include antidepressants and anti-seizure drugs.

In-office or at home physical therapy exercises also may be prescribed as treatment. Stretching exercises that focus on the chest muscles can help with pain and tightness related to inflammation.

The multidisciplinary team at the Advanced Lung Disease Program can determine the best treatment option for each patient.