Pleurisy: what kind of disease it is, causes, and whether it is contagious

A sharp pain in the side on inhalation — as if a needle were stuck between the ribs. This is often how pleurisy begins: the person breathes rapidly and shallowly and lies on the affected side. Let us explain what this disease is, where it comes from, and whether it is transmitted to other people.

What pleurisy is and what happens in the pleura

The pleura is a thin sheet of tissue that covers the lungs on the outside and lines the chest cavity on the inside. Between its layers there remains a narrow space with a small amount of fluid: it helps the layers slide against each other during inhalation. Pleurisy is inflammation of these layers. In the dry (fibrinous) variant, fibrin is deposited on the surface; in the exudative variant, fluid accumulates in the cavity; the same word also denotes the accumulation of pathological effusion when the inflammatory nature is not beyond doubt.

Causes of pleurisy

The most common cause is a viral infection. Pleurisies can be bacterial, viral, and allergic; infections, chest injuries, and tumors are also named among the causes. Pleurisy can be an independent disease, but more often it is secondary and reflects an acute or chronic process in the lungs, and it can be a manifestation of pneumonia. Effusion also appears in circulatory insufficiency, liver cirrhosis, and nephrotic syndrome — then the fluid is closer to a transudate.

Pleurisy and tuberculosis: are they always linked

No. Tuberculosis is among the possible causes, but it is not the only one and not the most common: pleurisy is more often caused by viruses. Tuberculosis is also mentioned among the causes for which treatment is carried out in a hospital. A separate detail is the composition of the fluid: in tuberculous pleurisy, the glucose level in it decreases. On hearing the diagnosis, one should not immediately apply tuberculosis to oneself: the cause is established by a doctor.

Is pleurisy contagious

Pleurisy is inflammation of the pleura, which has various causes (viruses, bacteria, allergy, injuries, tumors, tuberculosis), and the cause is established by a doctor. Pleurisy itself, as inflammation of the pleura, is not described as a disease transmitted from person to person.

How pleurisy manifests and how it is detected

The main symptom is sharp chest pain on inhalation. It intensifies with coughing, sneezing, and movements, and radiates to the shoulders and back. In dry pleurisy, pain also occurs when bending to the opposite side, a low-grade fever persists for a long time, more often toward evening, sweating appears, breathing becomes rapid and shallow, and the doctor auscultates a pleural friction rub. In the exudative variant, there come heaviness in one half of the chest, shortness of breath, and a dry cough; cyanosis and lagging of the affected half during breathing are noticeable.

The doctor examines and auscultates the chest and, if in doubt, refers to a specialist. Blood tests, radiography, ultrasound examination, and computed tomography may be needed. Pleural puncture is informative: the fluid is examined for color, cellular composition, protein, LDH, and the Rivalta test is performed. Transudate — protein less than 32 g/L and LDH less than 1.3 mmol/L; exudate — protein more than 36 g/L and LDH 1.75 mmol/L. On radiography, effusive pleurisy produces a homogeneous opacity with an oblique upper level if the fluid is more than a liter; with a smaller volume, the lower-lateral sinus is opacified.

A reference point for comparison is the normal composition of pleural fluid:

• relative density 1015, straw-yellow color, fully transparent, no odor;
• protein 15–25 g/L;
• LDH 1.4–1.7 mmol/L;
• glucose 2.1–2.2 mmol/L, pH 7.2.

Why pleurisy is dangerous and when to urgently consult a doctor

Usually pleurisy resolves on its own within a few days. But it can be a sign of a more serious condition, such as pneumonia, and severe cases and pleurisy against the background of tuberculosis or pulmonary artery thromboembolism are treated in a hospital. Purulent pleurisy is dangerous due to increasing toxemia; in empyema there may be hectic fever. Consult a doctor as early as possible — if the pain appears and disappears or occurs only on inhalation and with coughing, if it has not weakened within a few days, if streaks of blood are visible in the sputum, if shortness of breath has become regular.

Inflammation of the pleura itself is not a reason to call an ambulance; calling 103 or 112 is necessary if sudden chest pain lasts 15 minutes or longer, radiates to the arms, back, neck, or jaw, if it is difficult to breathe, if more than a couple of streaks of blood come up with a cough, and also if blood in the sputum is combined with lack of air, a very rapid heartbeat, or pain in the chest and upper back.

The material is for reference: it helps to understand what is being discussed, but does not replace a doctor's consultation — the cause of the pain and its seriousness are determined at an appointment.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer