Pleurisy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Pleuritis; pleural inflammation
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pleurisy is a disease state in which there is inflammation of the pleura, the lining of the pleural cavity, surrounding the lungs. A symptom associated with pleurisy or pleuritis is pleuritic chest pain. Pleuritic chest pain is defined as a sharp pain on either inspiration or expiration. Pleurisy can be caused by a variety of infectious and non-infectious causes.
Pathophysiology
The visceral pleura does not contain any noci-ceptors or pain receptors. The parietal pleura is innervated by somatic nerves that sense pain when the parietal pleura is inflamed. Inflammation that occurs at the periphery of the lung parenchyma can extend into the pleural space and involve the parietal pleura, thereby activating the somatic pain receptors and resulting in pleuritic pain. Parietal pleurae of the outer rib cage and lateral aspect of each hemidiaphragm are innervated by intercostal nerves. Pain is localized to the cutaneous distribution of those nerves. The phrenic nerve supplies innervations to the central part of each hemidiaphragm; when these fibers are activated, the sensation of pain is referred to the ipsilateral neck or shoulder.[1]
Risk Factors
Underlying lung disease, such as pneumonia or tuberculosis, has a higher risk for pleurisy.
Treatment
Prevention
Early treatment of bacterial respiratory infections can prevent pleurisy.
References
- ↑ Kass SM, Williams PM, Reamy BV (2007). “Pleurisy”. American Family Physician. 75 (9): 1357–64. PMID 17508531. Retrieved 2013-04-30. Unknown parameter
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Pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Farman Khan, MD, MRCP [2]
Overview
The visceral pleura does not contain any noci-ceptors or pain receptors. The parietal pleura is innervated by somatic nerves that sense pain when the parietal pleura is inflamed. Inflammation that occurs at the periphery of the lung parenchyma can extend into the pleural space and involve the parietal pleura, thereby activating the somatic pain receptors and resulting in pleuritic pain. Parietal pleurae of the outer rib cage and lateral aspect of each hemidiaphragm are innervated by intercostal nerves. Pain is localized to the cutaneous distribution of those nerves. The phrenic nerve supplies innervations to the central part of each hemidiaphragm; when these fibers are activated, the sensation of pain is referred to the ipsilateral neck or shoulder.[1]
References
- ↑ Kass SM, Williams PM, Reamy BV (2007). “Pleurisy”. American Family Physician. 75 (9): 1357–64. PMID 17508531. Retrieved 2013-04-30. Unknown parameter
|month=ignored (help)
Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farman Khan, MD, MRCP [2] Luke Rusowicz-Orazem, B.S.
Overview
Pleurisy is commonly caused by bacterial and viral infections, as well as cancer. Other causes include drug side effects, physical chest trauma, and autoimmune conditions.
Causes[1]
Life Threatening Causes
- Bronchogenic carcinoma
- Lung cancer
- Lung infection
- Mycobacterium tuberculosis
- Pneumonia
- Pulmonary Embolism
- Pulmonary Infarction
- Lung Cancer
- Tuberculosis
- Renal failure
- Respiratory tract infection
Common Causes
- Pneumonia
- Pulmonary Embolism
- Pulmonary Infarction
- Lung Cancer
- Tuberculosis
- Chest Trauma
- Cardiac Surgery
- Dressler syndrome
Causes by Organ System
Causes in Alphabetical Order
- Alferon n
- Amiodarone
- Asbestos exposure
- Bacterial pleural infection
- Bronchiectasis
- Bronchitis
- Bronchogenic carcinoma
- Cardiac surgery
- Chest trauma
- Churg-strauss syndrome
- Dressler syndrome
- Familial mediterranean fever
- Inerferon alfa
- Infergen
- Intron a
- Ivacaftor
- Juvenile chronic arthritis
- Lemierre syndrome
- Lung cancer
- Lung infection
- Methotrexate
- Methysergide
- Mycobacterium tuberculosis
- Nitrofurantoin
- Oesophageal rupture
- Oxcarbazepine
- Pegintron
- Penetrating chest injury
- Pentamidine isethionate
- Pleural cancer
- Pleural effusion
- Pneumonia
- Pramipexole
- Pulmonary embolism
- Pulmonary infarction
- Radiotherapy
- Recurrent hereditary polyserositis
- Renal failure
- Respiratory tract infection
- Rheumatoid arthritis
- Rib fracture
- Roferon-a
- Sarcoidosis
- Sjogren syndrome
- Sulfasalazine
- Systemic lupus erythematosus
- Tuberculosis
- Viral pleural infection
- Wegener granulomatosis
References
- ↑ Light RW (2011). “Pleural effusions”. The Medical Clinics of North America. 95 (6): 1055–70. doi:10.1016/j.mcna.2011.08.005. PMID 22032427. Unknown parameter
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Differentiating Pleurisy from other Diseases
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Pleurisy from other Diseases
Inflammatory Conditions
- Empyema, pleural
Miscellaneous Syndromes
- Renal failure, chronic
Gastrointestinal Disorders
Autosomal Recessive Conditions
- Recurrent hereditary polyserositis
Cardiac and Vascular Conditions
Autoimmune Conditions
Infectious Conditions
Iatrogenic Conditions
References
Epidemiology and Demographics
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References
Risk Factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Underlying lung disease, such as pneumonia or tuberculosis, has a higher risk for pleurisy.
References
Natural History, Complications and Prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Complications
- Breathing difficulty
- Collapsed lung due to thoracentesis
- Complications from the original illness
Prognosis
Recovery depends on what is causing the pleurisy.
References
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Case Studies
Case Studies
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