Dear Alice,

What is pleurisy? How do you get it? Is it contagious? How do you treat it? Is it chronic or recurring?

Dear Reader,

Pleurisy involves the membranes that line the chest cavity and surround the lungs. These two layers of membrane are separated by a thin layer of fluid that allows them to slide smoothly by one another with each breath. If the membranes become inflamed, they rub against one another, causing sharp pain associated with breathing or coughing. This is pleuritis or pleurisy. Typically, there is no pain between breaths. Other symptoms may include shortness of breath, a dry cough, or fever and chills.

Pleurisy is not a disease in and of itself; rather, it is a symptom of an underlying condition, such as a viral infection, a bacterial infection (e.g., pneumonia or tuberculosis), or an autoimmune condition (e.g., lupus or rheumatoid arthritis). As such, pleurisy itself is not contagious, but some of its possible underlying conditions, such as tuberculosis, can be very contagious. In addition to being caused by illness, pleurisy can also develop after a chest injury or heart surgery. Sometimes its cause is unknown. In order to try to diagnose the underlying cause, health care providers may listen to the lungs with a stethoscope, take an x-ray, run a blood test, and/or use thoracentesis (removal of a fluid sample from the chest with a needle).

The symptoms of pleurisy can be alleviated by treating the underlying illness. Bacterial infections can be treated with antibiotics. Non-steroidal anti-inflammatory drugs (NSAIDS) can be used to alleviate symptoms in the case of viral infections, which are normally left to run their own course. Prescription codeine can be used to treat coughing and pain.

As a potential complication of various illnesses, pleurisy can be chronic or reoccur, with varying levels of severity. Someone with severe chest pains that go away when they hold their breath or are associated with a fever may want to see a health care provider to diagnose possible pleurisy and any underlying health problems.


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