The pleura are membranes that surround and contain the lungs and separate them from the chest wall, diaphragm, and heart.
Conditions that affect the pleura of the lung include:
- Pleurisy (pleuritis): Inflammation of pleural membranes
- Pleural effusion: Excess fluid in the pleural cavity
- Hemothorax: Blood accumulation in the pleural cavity
- Empyema: Accumulation of pus in the pleural cavity
- Pneumothorax: Accumulation of air within the pleural cavity between the outside of the lung and the inside of the rib cage.
- Pleural tumors: Cancerous tumors that originate from the pleura (e.g., mesothelioma) or that have spread (metastasized) from another site to the pleura, and benign tumors that originate from the pleura
What Are Symptoms of Pleural Diseases?
Symptoms of pleural diseases can vary depending on the condition, and may include:
- Shortness of breath
- Impaired breathing
- Cough
- May be dry or may contain sputum or blood
- Shallow, rapid breathing
- Fever
- Anxiety/restlessness
- Increased heart rate
- Bluish discoloration of skin (cyanosis)
- Unexpected weight loss
- Respiratory failure
What Causes Pleural Diseases?
Causes of pleural diseases can include:
- Infections from viruses, bacteria, fungi, parasites, or tuberculosis
- Certain cancers such as mesothelioma, lung cancer, pleural tumors, or metastases (cancer that has spread from other parts of the body)
- Hole in the lung (pneumothorax)
- Blood clot in the lung (pulmonary embolism)
- Pneumonia
- Chronic obstructive pulmonary disease (COPD) or other lung disease
- Ruptured air blisters (blebs)
- Mechanical ventilation
- Chest trauma/injury to the chest such as bruised or broken ribs
- Collagen vascular diseases such as lupus, rheumatoid arthritis, sarcoid disease, or scleroderma
- Gastrointestinal disease, such as pancreatitis or peritonitis
- Adverse reactions to certain drugs such as methotrexate (Rheumatrex, Trexall), penicillin, and chemotherapy drugs
- Uremia
- Radiation therapy
- Sickle cell disease
- Asbestos
- Human immunodeficiency virus (HIV)
- COVID-19 virus
- Complications from chest/heart surgery
- Congestive heart failure
- Liver disease
How Are Pleural Diseases Diagnosed?
Pleural diseases are diagnosed with a patient history and physical examination. Tests to determine what disease is present may include:
- Chest X-ray
- Computerized tomography (CT) scan
- Electrocardiogram (ECG)
- Echocardiogram (“echo”)
- Pulse oximetry
- Thoracentesis: removal of fluid from around the lung
- Blood tests to check for infection or certain proteins that could indicate a heart attack
What Is the Treatment for Pleural Diseases?
Treatment for pleural diseases depends on the condition and may include:
- Medications
- Pain relievers
- Corticosteroids such as prednisone or dexamethasone for inflammation
- Antibiotics to treat bacterial infections
- Blood thinners to dissolve blood clots
- Diuretics to help rid the body of excess fluids
- Sclerosing agents that can help prevent fluid accumulation
- Chemotherapy or radiation therapy for cancer
- Thoracentesis or thoracostomy to drain fluid and/or blood from around the lungs
- Chest tube or needle aspiration to drain the air in a pneumothorax or to drain the infection
- Opening in the chest to collect fluid drainage (stoma)
- Stopping medication that causes the pain
- Never stop taking a prescribed medication without first talking to your doctor
- Surgery
From 
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Reviewed on 7/27/2022
References
REFERENCES:
Image source: iStock Images
http://emedicine.medscape.com/article/299959-overview
https://www.uofmhealth.org/health-library/tj8148
https://www.uptodate.com/contents/pleuritic-chest-pain-the-basics?search=pleurisy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.uofmhealth.org/conditions-treatments/pulmonary/pleural-diseases
Image source: iStock Images
http://emedicine.medscape.com/article/299959-overview
https://www.uofmhealth.org/health-library/tj8148
https://www.uptodate.com/contents/pleuritic-chest-pain-the-basics?search=pleurisy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.uofmhealth.org/conditions-treatments/pulmonary/pleural-diseases