Presentation
DIAGNOSTIC TESTS Because pleuritic chest pain may be a presenting complaint for pneumonia, pulmonary embolism, or pneumothorax,1,9 all patients presenting with this symptom should have chest radiography. [aafp.org]
Pain receptors are present on the parietal pleura. [online.epocrates.com]
Thus, risk factors of PE should be considered in pediatric patients presenting with symptoms suggesting infectious pleuritis. [ncbi.nlm.nih.gov]
Improve your interpretation of presenting symptoms with 41 new topics and 7 new references in the Differential Diagnosis section. [books.google.com]
Entire Body System
- Severe Pain
Some symptoms associated with pleurisy are as follows: Coughing up blood Fever Headache Muscle ache Joint pain Pain developing slowly over several days Severe pain that may fade in a few days Breathlessness Unexplained weight loss © Newsmax. [newsmax.com]
Symptoms Usually the first sign of pleurisy is a sudden chest pain. The pain may be very mild or very severe. Sometimes the pain is only felt while breathing deeply or coughing. [cedars-sinai.edu]
The pain associated with breathing is treated with anti-inflammatory medications (e.g., nonsteroidal anti-inflammatory drugs, or NSAIDs). Stronger pain medications may be required for more severe pain. [medbroadcast.com]
If you have severe pain, you may need prescription cough or pain medicine. You may also be able to relieve pain by lying on the painful side or pressing a pillow against it. [peoriaearnosethroat.com]
- Anemia
Sickle cell anemia is a potential cause of pleurisy. It is characterized by the presence of red blood cells shaped like sickles. The most common cause is a viral infection of the lungs spreading to the pleural cavity. [medicalnewstoday.com]
Some conditions that can be causes of symptoms of pleuritic pain are listed as follows: Chest injury Pneumonia Inflammation Collapsed lung Sickle cell anemia Immune system disorder B lood clots Pancreatitis Fungal or parasitic infections Chest or lung [newsmax.com]
Other causes: Uremia Pulmonary embolism Sickle cell anemia Radiotherapy Asbestosis (related to asbestos) Exposure to ammonia HIV infection Some cases are due to diseases of the organs of the abdominal cavity, such as: Liver (for example liver abscess) [hickeysolution.com]
】*malignant ameloblastoma 【悪性高熱症】*malignant hyperthermia 【悪性黒色腫】*malignant melanoma (略 MM) 【悪性腫瘍】*malignant tumor *malignancy 【悪性新生物】*malignant neoplasm (=悪性腫瘍) 【悪性組織球症】*malignant histiocytosis (略 MH) 【悪性中皮腫】*malignant mesothelioma 【悪性貧血】*pernicious anemia [medo.jp]
- Malaise
[…] sharp pain or even agonizing crushing chest pain mimicking MI [51] pericardial friction rub; approximately 80% will have accompanying pleural effusions (dullness to percussion and decreased breath sounds at the lung bases) Uremia known renal impairment, malaise [online.epocrates.com]
[…] associated with the pain should raise clinical suspicion for pulmonary embolism, pneumonia, and pneumothorax.5,9,23 Features that are associated with life-threatening causes of pleuritic pain are listed in Table 3.3–5,8,9,21,22 Other symptoms, such as malaise [aafp.org]
- Hodgkin Lymphoma
HTLV-1 infection is associated with Sjögren syndrome, as well as with the following diseases: Adult T-cell leukemia/non-Hodgkin lymphoma (lifetime risk, 5%) – These are commonly associated with hypercalcemia and skin involvement Chronic inflammatory syndromes [emedicine.medscape.com]
- Intermittent Fever
[…] cramp 【間欠性跛行】*intermittent claudication =間歇的跛行 【間欠痛】*intermittent pain 【間欠熱】*intermittent fever 【間欠熱マラリア】*intermittent malaria 【間質性胃炎】*interstitial gastritis 【間質性腎炎】*interstitial nephritis 【間質性舌炎】*interstitial glossitis 【間質性肺炎】*interstitial pneumonia [medo.jp]
Respiratoric
- Pleural Effusion
This fluid is called pleural fluid. When there is excessive accumulation of fluid in between the pleural space this condition is referred to as pleural effusion or some call it as pleurisy. [tandurust.com]
Exudative pleural effusions meet at least one of the following criteria, whereas transudative pleural effusions meet none: Pleural fluid protein/serum protein >0.5 Pleural fluid LDH/serum LDH >0.6 Pleural fluid LDH more than two-thirds the normal upper [accesspharmacy.mhmedical.com]
If you have pleural effusion, you may need to have the fluid drained through a tube that the doctor inserts in your chest. In some cases of pleural effusion, you may need pleurodesis. [peoriaearnosethroat.com]
- Pleuritic Pain
Presentation Patients with pleuritic pain present in different ways depending on the underlying cause. Pleuritic pain typically is localized to the area that is inflamed or along predictable referred pain pathways. [aafp.org]
Other causes of pleurisy and pleuritic pain There are other more serious causes of pleuritic pain but these are much less common than viral pleurisy. [pickeringmedicalpractice.co.uk]
- Pleural Disorder
Blood Tests Blood tests can show whether you have an illness that increases your risk of pleurisy or another pleural disorder. [nhlbi.nih.gov]
Disorders of the pleura include Pleurisy - inflammation of the pleura that causes sharp pain with breathing Pleural effusion - excess fluid in the pleural space Pneumothorax - buildup of air or gas in the pleural space Hemothorax - buildup of blood in [icdlist.com]
References [ edit ] ^ a b c d e "What Are Pleurisy and Other Pleural Disorders?". NHLBI. 21 September 2011. Archived from the original on 8 November 2016. Retrieved 1 November 2016. ^ a b c d "What Causes Pleurisy and Other Pleural Disorders?". [en.wikipedia.org]
Pleural effusion. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/pleural-effusion. Updated October 2017. Accessed August 29, 2018. [cancercarewny.com]
- Painful Cough
According to the Mayo Clinic, the symptoms of pleurisy include: Chest pain that worsens when you breathe, cough or sneeze Shortness of breath, because you will try to minimize breathing in and out to prevent pain Cough (in some cases) Fever (in some cases [ksl.com]
[…] in the side and lower part of the chest Pain along the shoulders, neck, and belly Pain when you move your chest, such as breathing and coughing A dry cough Fever Rapid heartbeat Rapid and shallow breathing Diagnosis You will be asked about your symptoms [cancercarewny.com]
(The inner layer of the pleura next to the lungs has no pain nerves.) The pain is often described as a stabbing sensation, and may range from moderate to very severe. The pain is usually made worse by breathing deeply or coughing. [mydr.com.au]
[…] within 2 to 3 weeks after myocardial infarction (MI), or from 3 days to 1 year after coronary artery bypass surgery; chest pains usually precede fever and can vary from dull ache to pleuritic sharp pain or even agonizing crushing chest pain mimicking [online.epocrates.com]
- Tachypnea
Fever with chills Loss of appetite Dry cough There is collection of fluid inside the chest cavity which makes breathing difficult and causes the following symptoms: Cyanosis (bluish skin color) Dyspnea (shortness of breath) Coughing Rapid breathing (tachypnea [epainassist.com]
[…] inflammation, rub together with each breath, causing a rough grating sound–“friction rub”–heard with a stethoscope; fluid accumulation separates parietal and visceral pleurae, ↓ chest pain; large effusions compromise respiration and may cause coughing, SOB, tachypnea [medical-dictionary.thefreedictionary.com]
Sudden pain and dyspnea Tachycardia, hyperresonance, decreased breath sounds, decreased wall movement Thin pleural line Typically not indicated May be normal in small pneumothorax Sinus tachycardia Pulmonary embolism Prior embolism or clot Tachycardia, tachypnea [aafp.org]
*erythema multiforme exudativum-like drug eruption 【多形性紅斑】*erythema multiforme[L] 【多形性腺腫】*pleomorphic adenoma 【多形性肉腫】【多形型肉腫】*pleomorphic sarcoma 【多形皮膚萎縮症】*poikiloderma 【多血球症】*polyglobulism 【多血症】*polycythemia ^=赤血球増加症 【多言症】*hyperlalia 【多呼吸】*polypnea *tachypnea [medo.jp]
Gastrointestinal
- Abdominal Pain
On the day of admission, she presented to ED with vomiting, watery diarrhea, abdominal pain, chest pain, and respiratory distress. Laboratory findings showed hypoalbuminemia and proteinuria. [ncbi.nlm.nih.gov]
Grey-Turner sign, Cullen sign, Fox sign, Chvostek sign, Trousseau sign, tachycardia, hypotension, abdominal distention Chronic pancreatitis history of alcohol abuse, nausea, vomiting, epigastric abdominal pain radiating to the back, steatorrhea, malnutrition [online.epocrates.com]
Common side effects of these antibiotics include diarrhea, nausea, and abdominal pain. If the patient has tuberculosis, more specialized antibiotics are used for a longer period of time. If the infection is viral, antibiotics will not be effective. [health24.com]
pain *abdominalgia 【腹部外傷】*abdominal trauma 【腹部狭心症】*abdominal angina 【腹部出血】*abdominal hemorrhage *abdominal bleeding 【腹部腫瘍】*abdominal tumor 【腹部疝痛】*celialgia 【腹部大動脈瘤】*abdominal aortic aneurysm 【腹部癲癇】*abdominal epilepsy 【腹部ヘルニア】*laparocele (=腹壁瘤) 【腹部膨大】 [medo.jp]
Cardiovascular
- Chest Pain
Pleuritic chest pain Pleuritic chest pain is a symptom of pleurisy and is caused by the parietal pleura becoming inflamed. [independentnurse.co.uk]
SOURCES: American College of Gastroenterology: "Non-Cardiac Chest Pain." Merck Manuals Online Medical Library: "Lung and Airway Disorders: Symptoms" and "Chest Pain." National Lung Health Education Program: "Chest Pain." [webmd.com]
DIAGNOSTIC TESTS Because pleuritic chest pain may be a presenting complaint for pneumonia, pulmonary embolism, or pneumothorax,1,9 all patients presenting with this symptom should have chest radiography. [aafp.org]
Infections of the skin such as shingles can cause chest pain, as can bruises. The doctor may press on your chest. [emedicinehealth.com]
Musculoskeletal
- Back Pain
This pain can effect the chest cavity in either the front or back of the cavity, and sometimes patient's have back or shoulder pain. [medicinenet.com]
Grey-Turner sign, Cullen sign, Fox sign, Chvostek sign, Trousseau sign, tachycardia, hypotension, abdominal distention Chronic pancreatitis history of alcohol abuse, nausea, vomiting, epigastric abdominal pain radiating to the back, steatorrhea, malnutrition [online.epocrates.com]
- Scapulalgia
】*ectrodactyly/*ectrodactylia/*ectrodactylism 【欠肢症】*ectromelia 【欠肢体】*ectromelus 【欠乏症】*deficiency 【腱炎】*tendinitis 【腱鞘炎】*peritendinitis *tendovaginitis 【腱膜炎】* *aponeurositis 【肩関節亜脱臼】*subluxation of shoulder 【肩関節周囲炎】*scapulohumeral periarthritis 【肩甲骨痛】*scapulalgia [medo.jp]
Urogenital
- Kidney Failure
Rare causes — Radiation therapy (for cancer), a collapsed lung (pneumothorax) and pericarditis (as with severe kidney failure or following a heart attack) all can be associated with pleurisy. [health.harvard.edu]
Serious pathology of the heart, for example heart failure or pericarditis. Kidney diseases : kidney failure, in this case pleuritis is called uraemic. Reaction to drugs such as methotrexate, nitrofurantoin and methysergide. [hickeysolution.com]
failure injury, from a rib fracture, collapsed lung, esophagus rupture, blood clot, or material such as asbestos drug reactions, from certain drugs used to treat tuberculosis (isoniazid), cancer (methotrexate, procarbazine), or the immune disorders mentioned [encyclopedia.com]
Neurologic
- Irritability
However, when this tissue is inflamed or infected, it becomes irritated and swollen, causing significant pain. This condition is known as pleurisy or pleuritis. This condition has a grim fame. [healthline.com]
Pleurisy occurs when the pleural surfaces rub against one another, due to irritation and inflammation. Infection within the pleural space is the most common irritant, although the abnormal presence of air, blood, or cells can also initiate pleurisy. [encyclopedia.com]
[…] pancreatitis, peritonitis, inflammatory bowel disease [IBD]) Inhaled toxins (e.g., cleaning agents, asbestos) Lung diseases (e.g., sarcoidosis, mesothelioma) Pulmonary embolism (formation of a blood clot in the lungs) Trauma (e.g., rib fractures, chest tube irritation [healthcommunities.com]
Irritation and inflammation of the pleura presents with symptoms of sharp lancing, fleeting pain in the chest that is exacerbated by deep breathing, coughing, sneezing, and Valsalva (forced expiration against a closed airway) or Mueller maneuvers (reverse [online.epocrates.com]
Irritation and inflammation of the pleura presents with symptoms of sharp lancing, fleeting pain in the chest that is exacerbated by deep breathing, coughing, sneezing, or Valsalva (forced expiration against a closed airway) and Mueller manoeuvres (reverse [bestpractice.bmj.com]
Workup
Microbiology
- Staphylococcus Aureus
Many different types of bacteria, including Haemophilus influenzae and Staphylococcus aureus, can also cause pneumonia, as well as viruses and, more rarely, fungi. [nhs.uk]
aureus (MRSA) is a common cause of bacterial pleurisy which can sometimes affect hospital patients. [your.md]
Bacterial skin infections (such as with Pseudomonas aeruginosa or Staphylococcus aureus), dermatitis, dehydration, and low blood sodium levels have been reported. [health24.com]
Pleura
- Pleural Effusion
This fluid is called pleural fluid. When there is excessive accumulation of fluid in between the pleural space this condition is referred to as pleural effusion or some call it as pleurisy. [tandurust.com]
Exudative pleural effusions meet at least one of the following criteria, whereas transudative pleural effusions meet none: Pleural fluid protein/serum protein >0.5 Pleural fluid LDH/serum LDH >0.6 Pleural fluid LDH more than two-thirds the normal upper [accesspharmacy.mhmedical.com]
If you have pleural effusion, you may need to have the fluid drained through a tube that the doctor inserts in your chest. In some cases of pleural effusion, you may need pleurodesis. [peoriaearnosethroat.com]
- Pleural Rub
Breathing difficulty if the accumulation of the fluid is large in the pleural space. The classical sign of pleural rub can be elicited by a stethoscope. It is the rubbing sound of the two pleural layers. Cough Loss of appetite. [tandurust.com]
Doctors usually check for a sound caused by pleurisy, often described as a pleural "rub," by listening for the creaky, scratchy sound of the pleura rubbing together during a breath. [medbroadcast.com]
Your doctor may hear what is known as a pleural rub — a squeaky rubbing sound in the chest. This is a classic sign of pleurisy. Tests The following tests may be used to help diagnose the cause of pleurisy. [mydr.com.au]
[…] a pleural rub—a squeaking or grating sound made when the pleural linings rub together—results. [uspharmacist.com]
- Pleural Adhesions
People with pleural adhesions have: Recurrence of frequent pleuritis, Chronic pain, Short of breath. [hickeysolution.com]
Treatment
Acupuncture and herbal treatments have been suggested as treatments for pain, inflammation, breathing trouble, mucus buildup, and infection. [sharecare.com]
Treatment For Viral Pleurisy External splinting of the chest wall can reduce the pain of pleurisy. Treating the underlying cause like tuberculosis, heart disease or kidney disease will reduce the effusion. [tandurust.com]
NSAIDs (particularly indomethacin), along with opioid analgesics, remain the mainstay of treatment for pleurisy; identification and treatment of the primary cause are also important. [uspharmacist.com]
Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. [betterhealth.vic.gov.au]
Treatment of pleurisy typically consists of pain management with nonsteroidal anti-inflammatory drugs, as well as specific treatments targeted at the underlying cause. [aafp.org]
Prognosis
Prognosis The outcome of treatment may depend on the seriousness of the underlying disease. Most cases of pleuritis of unknown cause heal with time. [diagnose-me.com]
Prognosis Prompt diagnosis, followed by appropriate treatment, ensures a good recovery for most pleurisy patients. Generally speaking, the prognosis for pleurisy is linked to the seriousness of its cause. [medical-dictionary.thefreedictionary.com]
In case of infectious bacterial pleuritis, the prognosis is not defined and people can develop complications that could cause permanent damage. The time of restoration of viral pleuritis is quite long and it takes at least two weeks. [hickeysolution.com]
Outlook Pleurisy is treatable, and the prognosis is good, but complications can arise if it is left untreated. [medicalnewstoday.com]
Prognosis The outlook for pleurisy differs from person to person, depending on the cause. [healthand.com]
Etiology
The discussion is carried out on the lines followed by the majority of people in giving importance to their viral etiology and the viruses involved as agents of serositis are reported. [pubmed.ncbi.nlm.nih.gov]
Pleural fluid can be examined for further etiologic clues (Table 529 ). [aafp.org]
[…] accumulation separates parietal and visceral pleurae, decreased chest pain; large effusions compromise respiration and may cause coughing, shortness of breath, tachypnoea, cyanosis, rib retraction. pleuritis Pleurisy Pulmonary medicine Pleural inflammation Etiology [medical-dictionary.thefreedictionary.com]
Epidemiology
[Acute idiopathic pericarditis and pleuropericarditis : clinical, etiological and epidemiological studies in the period from 1969 to 1974]. Natali G, Farina E, Trotta A. Natali G, et al. Cardiol Prat. 1976 Jan-Jun;27(1):55-62. Cardiol Prat. 1976. [pubmed.ncbi.nlm.nih.gov]
The molecular epidemiology of asbestos and tobacco in lung cancer. Oncogene. 2002;21:7284–8. 33. Matchaba PT, Volmink J. Steroidsfortreating tuberculous pleurisy. Cochrane Database Syst Rev. 2000;(1):CD001876. [aafp.org]
Pathophysiology
Pathophysiology The pleural space is a potential space that can be filled with a variety of substances including transudative fluid, exudative fluid, pus, blood, air, or chyle. [online.epocrates.com]
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. [aafp.org]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
You may have less pain after this happens, because the fluid prevents the two layers of the pleura from rubbing together. If there is a large amount of fluid, it may prevent the lung from expanding when you breathe in. [peoriaearnosethroat.com]