How Long Does Pleurisy Last?

Pleurisy is a medical condition that causes chest pain and shortness of breath. It is swelling and irritation of the tissue between the lungs and chest wall/ rib cage. Pleura is a thin two-layer protective membrane that covers the lungs and also lines the inside of the chest wall. The two layers of pleura are normally lubricated by a thin layer of fluid between them, which helps them slide easily over each other when we breathe in and out.

Pleurisy is often caused by an infection. The infection may be viral or bacterial. The other common causes include:

• Asbestos-related disease (from home or work exposure)
• Certain cancers (lung, lymphoma, and mesothelioma)
• A blood clot that travels to the lung
• Rheumatoid arthritis
• Lupus (an autoimmune disorder)
• Reactions to certain medicines or cancer treatments
• Injury to the lung, for example from a fractured rib

The most common symptom of pleurisy is chest pain that may start suddenly. The pain is often described as a stabbing sensation that may be severe at times. It worsens with breathing. Other symptoms of pleurisy may include:

• Rapid, shallow breathing because of the pain
• Dry Cough
• Extreme weakness
• Chills and fever
• Shortness of breath or respiratory distress due to large amounts of fluid in the pleural space (known as pleural effusion) makes it difficult for the lungs to expand.

The following tests are usually helpful for the diagnosis of pleurisy:

• Chest X-rays
• Chest CT scan
• Thoracocentesis: If there is fluid build-up in the pleural space (pleural effusion), the doctor may drain the fluid and send it to be tested to help determine the cause of pleurisy.
• Sputum samples or throat swabs, and blood tests help diagnose infectious causes (viruses or bacteria).

Treatment for pleurisy usually involves relieving the pain and, treating the underlying cause.

• Chest pain: A physician may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen to ease the pain and fever.
• Underlying cause: If your pleurisy is caused by a viral infection, it'll usually get better on its own after a few days, however in a few conditions antiviral drugs may be needed if the symptoms are severe or the patient is already in poor health. Bacterial infection may be treated with antibiotics. Patients may need to be admitted to the hospital in very severe cases where the medications are usually given through injections or intravenously.
• Pleural effusion: Sometimes pleurisy causes a build-up of excess fluid around the lungs called pleural effusion. In this condition, the patient may develop shortness of breath. The fluid may need to be drained by inserting a needle or tube through the chest wall under general or local anesthesia.

Treatment for pleurisy may include:

• Anti-inflammatory medications, pain killers, antibiotics, antiviral drugs, and steroids
• Draining off the excess fluid 
• Medications to stop the fluid from building up again.

If the underlying cause is diagnosed and treated early, a complete cure is possible. Symptoms may sometimes recur after the first round of treatment, hence routine medical checkups are recommended. The doctor may recommend a few lifestyle modifications such as giving up smoking and taking sufficient rest. Sometimes patients affected by bacterial pleurisy may develop complications and hence such patients may require long-time antibiotics. The long term complications of severe pleurisy include:

• Lungs that may be blocked or can’t expand the way they should (atelectasis)
• Pus in your pleural cavity (emphysema)
• A sudden drop in blood flow (shock)
• A dangerous reaction to infection (sepsis)
• Inflammation can also make fluid buildup in your pleural cavity. This is called pleural effusion. 
• Sometimes, pain may not be a major complaint, but there may be breathing difficulty. In such cases, the doctor might give medications like diuretics, or might have a procedure to drain the fluid regularly.