Pleuritis Symptoms in Adults: Signs and Chest Pain

Pleuritis is inflammation of the pleura, the membrane around the lungs. The main symptom is sharp chest pain on inspiration. Below we review the typical signs, the nature of the pain, and how a doctor confirms the diagnosis.

What pleuritis is and why symptoms appear

The pleura is a thin sheet of tissue. It wraps the lungs and lines the chest cavity from the inside. Between the layers there is a narrow space with a small amount of fluid. The fluid helps the layers slide during breathing.

Pleuritis is inflammation of the pleura, sharp pain on breathing. There are dry pleuritis, with fibrin deposition on the layers, and exudative pleuritis, with fluid accumulation in the pleural cavity.

Causes: infections, chest trauma, tumors. More often pleuritis is secondary, that is, a consequence of processes in the lungs. The most common cause is a viral infection.

Inflammation of the pleura causes sharp pain on breathing. On auscultation, a pleural friction rub is detected.

Main symptoms of pleuritis in adults

The main symptom is sharp chest pain on inspiration.

• Pain on breathing.
• Cough.
• Elevated temperature.
• Shortness of breath.
• Radiation of pain to the shoulders and back.

In dry pleuritis, breathing is shallow and rapid. The person lies on the affected side to reduce pain. Low-grade fever persists, more often in the evening, along with sweating.

In exudative pleuritis, the pain changes in intensity. A feeling of heaviness appears in one half of the chest, shortness of breath, and a dry cough or cough with scanty sputum. Cyanosis and swelling of the neck veins may occur.

Pain in pleuritis: what it looks like

The pain is sharp. It intensifies with coughing, sneezing, and movement. In dry pleuritis, it occurs on breathing, coughing, and bending to the opposite side. It may radiate to the shoulders and back.

Can pleuritis occur without fever

Temperature is listed among the signs of pleuritis. In dry pleuritis, it is only low-grade and persists mainly in the evenings. The main sign is pain on breathing. In purulent pleuritis, the fever is hectic, with marked intoxication.

How a doctor confirms pleuritis

The doctor examines and auscultates the chest. If the cause is unclear, they refer the patient to a specialist. Examinations: blood tests, chest X-ray, ultrasound, CT.

X-ray confirms the presence of fluid. In exudative pleuritis, a homogeneous opacity with an oblique upper fluid level is seen, which is how diffuse pleuritis looks when the volume is more than a liter. With a smaller volume, the lower lateral sinus is opacified.

Pleural puncture shows the composition of the fluid. Transudate: protein less than 32 g/L, LDH less than 1.3 mmol/L, Rivalta test negative. Exudate: protein more than 36 g/L, LDH 1.75 mmol/L, test positive. Cytology: leukocytes indicate acute pleuritis, mononuclear cells indicate chronic.

Complications and when to see a doctor

Pleuritis usually resolves within a few days. But it can be a sign of a more serious condition, such as pneumonia. Among pleural disorders are pleural effusion, pneumothorax, and hemothorax. In purulent pleuritis, signs of toxemia increase.

See a doctor if: pain appears and passes or occurs only on breathing and coughing; the pain has not resolved within a few days; there are streaks of blood in the sputum; there is regular shortness of breath.

Pleuritis itself is not a reason to call an ambulance. 103 or 112 if sudden chest pain lasts 15 minutes or longer; the pain radiates to the arms, back, neck, or jaw; it is hard to breathe; there is more blood in the sputum than a few streaks.

Terms. Pleura is the membrane covering the lungs and lining the chest cavity. Exudate is fluid that forms during inflammation. Transudate is fluid that seeps without inflammation. Fibrin is a protein deposited on the layers in dry pleuritis.

This material is for reference. It does not replace a doctor's consultation.

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