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For further information, see CMDT Part 9-35: Pleuritis

Key Features

  • Irritation of the parietal pleura causes the pain associated with pleuritis

Clinical Findings

  • Pain

    • Localized, sharp, and fleeting

    • Worsened by cough, sneeze, movement, or deep breathing

  • Pain may be referred to the shoulder when there is irritation of the central portion of the ipsilateral diaphragmatic pleura

Diagnosis

  • The setting in which pain occurs can often narrow the broad list of potential causes

  • Usually caused by viral respiratory infections or pneumonia (including tuberculosis in endemic regions)

  • Other causes to consider include

    • Pulmonary embolism

    • Inflammatory disorders (serositis)

    • Malignancy

    • Drug reactions

  • In young, healthy individuals, pleuritis is usually due to a viral respiratory infection

  • Pleural effusion, pleural thickening, or pneumothorax require additional diagnostic and therapeutic measures

Treatment

  • Treatment is directed at the underlying disease

  • Anti-inflammatory analgesic medications are often helpful for pain relief

  • Opioids may be used if nonsteroidal anti-inflammatory medications are ineffective or are contraindicated, provided retention of airway secretions is not a concern

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