At a Pleurisy (pleurisy) the ribs and usually also the lung skin in the thorax become inflamed. These are the connective tissue envelopes around the lungs and on the inner wall of the rib cage. Typical symptoms include aches and pains when breathing "dry" pleurisy. When fluid accumulates, it is called "wet" pleurisy. Read all important information about signs, causes and therapy pleurisy!

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. J86J90J94A16ArtikelübersichtRippenfellentzündung

  • symptoms
  • causes
  • investigations
  • treatment
  • Course and prognosis

Quick Overview

  • Definition: In pleurisy (also pleurisy, pleurisy), the pleura, the pleura, inflamed. This two-part layer of tissue coats the chest cavity (pleura) and covers the lungs (lung pelt).
  • Watch out: Even though one usually speaks of pleurisy, the second layer of the pleura, the lung pelt, is usually also inflamed.
  • symptoms: severe, breath-dependent pain when breathing ("dry" pleurisy); in "wet" pleuritis, decreasing pain and, if necessary, difficulty in breathing, including respiratory distress with large accumulation of fluid (pleural effusion); possibly fever
  • Causes: Pneumonia, pulmonary embolism, pulmonary infarction, tuberculosis, viral infection (coxsackie B virus), autoimmune diseases (such as lupus erythematosus, rheumatoid arthritis), cancers etc.
  • Treatment: Treatment of the underlying disease (e.g., antibiotics for bacterial infection). Otherwise relief of symptoms, for example, with analgesics and antipyretic drugs.
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Pleurisy: symptoms

A pleurisy (or pleurisy) may cause different symptoms - depending on whether it is a "dry" pleurisy or one "wet" pleurisy is. The difference between the two is found in the so-called Pleural space (pleural cavity): This is the narrow, slightly fluid-filled space that separates the two thin leaves of the pleura:

The inner tissue layer of the pleura is called the lung pelt and covers the lungs. Externally, the pleura joins, lining the chest cavity inside. The ribs and pleura are connected to each other at an umber fold at the edge of the lung.

The fluid between the lung and the pleura, ie in the pleural space, can change during pleurisy:

  • "Dry" pleurisy (Pleuritis sicca): no additional fluid in the pleural space. In most cases, however, threads of fibrin (coagulation protein) are formed here, which intensifies the friction between the two leaves of the pleura.
  • "wet" pleurisy (Pleurisy exudative): additional accumulation of fluid between lung and pleura (pleural effusion)

Often a pleurisy affects only one side of the body. The left and right lungs, together with the pleural cavities, are separated from each other by the middle medullary space (mediastinum).

"Dry" pleurisy: symptoms

When a pleurisy usually both the pleura and the lung are inflamed. Only the pleura is sensitive to pain - but all the more so. The friction created by breathing between the two skins causes dry pleurisy severe, breath-dependent and stabbing chest pain, The deeper the patient inhales, the more it hurts. That's why many patients only breathe flat. Some also instinctively adopt a posture that relieves the inflamed side.

The dry pleurisy can also be painful to cough be accompanied. The pain usually occurs on one side. Depending on the severity of the inflammation, it can radiate to the shoulder.

Also typical for a pleurisy is a creaking or rubbing breath sound, the so-called leather rubbing. It arises because the pleura and pleura rub together in the inflamed areas with each movement of the ribcage.

If the pleurisy attacks the diaphragm (the muscle plate that lies under the lungs), hiccups can also occur.

"Damp" pleurisy: symptoms

With a pleural effusion, more fluid accumulates in the pleural space than normally. This can generally have different causes. If the pleural effusion forms in the course of a pleurisy, physicians speak of "Pleurisy exudativeSymptoms such as pain and rubbing of the leather are either absent or greatly reduced, and the effusion between the inflamed pleura leaves prevents them from rubbing against each other.

This often shows other symptoms in this form of rhinitis: Signs of pleural effusion may be a difficult breathing or even difficulty in breathing (Dyspnea). This happens when the effusion is so great that it squeezes the lung significantly. With a small effusion the patient can breathe normally.

Dry and moist pleurisy If pleurisy occurs over a long period of time, pleural effusion often develops (fluid buildup between the pleura and lung pelvis).

Transition from dry to damp

Often a moist pleurisy develops from a dry one. This means that the inflammation causes fluid to escape from the fine blood vessels (capillaries) and collects as an aqueous effusion in the pleural space. If the Pleural effusion purulent is, doctors speak of one pleural empyema, But he can also mostly blood consist (hemorrhagic pleurisy).

Sometimes accompanied fever the transition from a dry to a "wet" pleurisy.

Previous illness influences symptoms

Other symptoms of pleurisy depend on the underlying disease. Some examples:

At a lung infection High fever with chills and cough with sputum often occur. The pleurisy develops as a result of tuberculosisMany patients also suffer from coughing, fatigue and night sweats.

At a Coxsackie B virus infection (Bornholm disease), sufferers have difficulty breathing as well as spasmodic pain in the chest and upper abdomen. Such pains can also occur if pleurisy is the result of upper abdominal disease, for example, one pancreatitis (Pancreatitis).

Also cancers such as a malignant tumor of the pleura (pleural mesothelioma) are possible causes of pleurisy. Signs of pleural mesothelioma are more advanced than those of "normal" pleurisy.