Pleurisy overview

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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

  1. 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)

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