Health: PLEURISY

Lungs are covered by two layers known as pleura, which protect the lung tissue. Pleurisy is the condition of inflammation of these coverings of the lungs. It can occur in both genders at any age depending on the cause. Pleurisy most commonly occurs due to infections. Whereas in western countries it occurs commonly due to viral infection, in tropical countries tuberculosis and bacterial infections are the most common cause. Fungal and parasitic infections can also invade the pleura from other parts of the body resulting in pleurisy. Disorders like rheumatoid arthritis, systemic lupus erythematosus cause inflammation of the joints as well as the pleura. Lung diseases which occur due to chronic occupational exposure to irritant substances like coal, silica, asbestos, e.t.c. can cause inflammation of the airways as well as the pleura. It can occur as a sequel to myocardial infarction and also as a complication of coronary by-pass surgery of the heart. Tumours of the lung can spread to the coverings and inflame them causing pleurisy. It can also be due to tumours of the pleura itself. Pleurisy can also be due to some trauma to the lung. Classic symptom of pleurisy is severe chest pain which occurs over the affected site. This pain is aggravated by breathing. It occurs due to rubbing of the inflamed layers of pleura together as air enters the lung. Along with pain, there is cough with mucous and or blood, increased respiratory rate and laboured breathing. Fever and other signs may be present depending on the underlying cause if the inflammation continues unabated, there is oozing of liquid from the pleura. This may be in the form of thick viscid pus or yellow coloured/clear liquid depending on the underlying cause. The person gets sicker due to the collection of this fluid. There is further difficulty in breathing and more severe chest pain. The breathlessness increases in lying down position compelling him to sit up. Thus he is not able to rest adequately making him more ill. In pleurisy due to chronic conditions like tuberculosis or malignancy, one also has loss of appetite along with other symptoms. This makes the individual more sick. Ultimately the person becomes confined to bed, feeling miserable. The infection or disease affecting the pleura can also spread to the lung tissue or even another lung via direct spread or through blood vessels, thus damaging it also. Through the blood stream, the infection has the potential to spread to reach the brain causing infection of the coverings of the brain or brain substance. This is manifested in the form of severe headache, convulsions and or paralysis of limbs, e.t.c. neurological abnormalities. If one does not receive treatment in time for pleurisy, the illness progresses and the individual can die due to respiratory failure or its complications. Therefore it is vital to diagnose and treat pleurisy at the earliest. Any individual complaining of localized chest pain, increasing with breathing needs to be investigated for pleural inflammation. Chest pain anywhere, apart from the heart, i.e. left sided can be for multiple other causes like muscular pains or even anxiety. But it is only after excluding a serious condition like pleurisy, one can receive treatment for benign conditions like muscular pain. Investigations include a complete blood count to evaluate for bacterial or other infection and an X-ray of the chest. If available and accessible, C.T. (Computerized tomography), scan of the chest can be done to see the pleural affection in greater detail. It also shows a pleural or pulmonary tumour if present as the underlying cause for pleurisy. Treatment consists of anti-inflammatory drugs to reduce the inflammation of the pleura. In case of an associated effusion, i.e. fluid collection in the pleura, it needs to be drained mechanically. Treatment of the underlying cause helps in total improvement of the condition. Pleurisy is a serious condition needing urgent medical attention. Therefore even if one has a doubt, he or she should be investigated and treated for it. E-mail-rachna212002@yahoo.co.uk