Pleuriitti

Pleuriitti, also known as pleuritis, is inflammation of the pleura, the two thin membranes that surround the lungs and line the chest cavity. The condition commonly causes sharp, localized chest pain that worsens with deep breathing, coughing, or sneezing. Mild fever, shortness of breath, or a dry cough may accompany the pain. A pleural friction rub may be heard with a stethoscope.

Causes are varied and include infections (viral or bacterial pneumonia, tuberculosis), autoimmune diseases (such as systemic lupus erythematosus or rheumatoid arthritis), pulmonary embolism, malignancy, heart failure, chest trauma, or drugs. In many cases an identifiable cause is found, but some instances are idiopathic.

Diagnosis typically involves medical history and physical examination, followed by imaging such as chest X-ray or ultrasound to detect pleural effusion or other lung problems. Thoracentesis may be performed to remove pleural fluid for analysis (including protein, LDH, cell count, cultures, and cytology) to determine infection, inflammation, or cancer. Blood tests and ECG may help identify infection, autoimmune disease, or cardiac causes of chest pain.

Treatment depends on the underlying cause. Pain relief is usually provided by nonsteroidal anti-inflammatory drugs or acetaminophen; corticosteroids may be used in some inflammatory or autoimmune cases. If infection is present, appropriate antibiotics are given. When fluid accumulates, thoracentesis or chest tube drainage may be necessary. Recurrent pleuritis or large effusions may require procedures such as pleurodesis or the use of a pleural catheter. Managing the underlying condition is essential.

Prognosis varies; many cases improve with treatment, but pleural effusions or recurrent pleuritis can occur, particularly with cancer, pulmonary embolism, or chronic inflammatory diseases. See also pleural effusion, pneumothorax, thoracentesis, and pleurodesis.