How long pleurisy lasts depends on its cause. A patient with confirmed pleural effusion may require a procedure called thoracentesis, in which some chest fluid is removed and sent to a laboratory to be tested. For example, in patients with suspected pulmonary embolism, a lung scan or CT scan of the lungs may be used to confirm the diagnosis.
Ultrasound or chest computed tomography (CT) - If your doctor suspects a pleural effusion, an ultrasound or CT scan of the chest can confirm that there is an abnormal pocket of fluid in the lungs.ĭepending on the results of these preliminary tests, additional tests may be necessary to confirm the diagnosis. Blood tests - Specific blood tests can be used to help diagnose pneumonia, pulmonary embolism and lupus. A chest X-ray - This can show areas of pneumonia, pulmonary tuberculosis, pulmonary embolism, pleural effusion or a cancerous nodule. Depending on the results of your physical examination and the suspected cause of your pleurisy, the doctor then may recommend: He or she also will listen with a stethoscope to check for a pleural friction rub, the rough, scratchy sound of the inflamed layers of pleura sliding past each other during breathing. Your doctor will check for signs of pleural effusion by gently tapping your chest wall. To confirm the diagnosis, he or she will examine you, paying special attention to your lungs. He or she also may ask whether you have been anywhere where you may have been exposed to tuberculosis. Your doctor will ask about your medical history, including your history of smoking. A person with lung cancer may have unexplained weight loss and cough. A pulmonary embolus may be associated with shortness of breath, a low-grade fever and a cough that brings up small amounts of blood. For example, a person with pneumonia may have a high fever, shortness of breath and a cough that produces thick, yellow or dark sputum (mucus). In rare cases, the chest pain of pleurisy is a fairly constant, dull ache.ĭepending on the specific cause of pleurisy, other symptoms may be present. To ease chest pain from pleurisy, a person with pleurisy often lies on the affected side as a way of limiting movement of the chest wall. The pain may start and remain in one specific area of the chest wall, or it may spread to the shoulder or back. Pleurisy typically causes a sharp chest pain (pleuritic chest pain) that worsens with breathing in or coughing. These cases are rare, and usually are presumed to be caused by a viral infection. No identifiable cause - Pleurisy can develop for no clear reason despite extensive investigation. 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 accompanied by pleurisy. 
Connective tissue disorders - Systemic lupus erythematosus (SLE or lupus) and other connective tissue disorders can cause inflammation of the pleura. When pleurisy occurs because of lung cancer, a bloody pleural effusion is common. Lung cancer - Pleurisy can develop in people with lung cancer. In people with pulmonary embolism, symptoms of pleurisy tend to occur when the pulmonary embolism is fairly small and has lodged in a part of the lungs near the pleura. 
Pulmonary embolism - A pulmonary embolism is a blood clot that has floated through the bloodstream and lodged in the lungs.
Viral lung infections, especially epidemic pleurodynia (an infection usually caused by coxsackieviruses or echoviruses), also can cause pleurisy. When pleurisy is caused by a bacterial lung infection, it can be associated with a pus-filled pleural effusion (called an empyema). In developing nations where tuberculosis is common, pulmonary tuberculosis is another important cause. Lung infection - In industrialized nations, bacterial pneumonia (lung infection) resulting from staphylococci, pneumococci, Haemophilus influenzae or other organisms is a frequent cause of pleurisy.Pleurisy can develop many ways, including: Depending on its cause, pleurisy can be associated with an accumulation of fluid in the space between the lungs and chest wall (called a pleural effusion) or it can be dry pleurisy, which has no fluid accumulation. Pleurisy means inflammation of the pleura, the membrane that lines the lungs within the chest cavity.
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