Pleurisy

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Treatment

Pleurisy treatment is based on the underlying cause for the condition. The goals of treatment are to relieve pain, remove excess fluid, air, or blood from the pleural space, and treat the cause.

Patients who have pleurisy often are advised to get plenty of rest. In most cases, lying on the affected side can make the condition less painful. It also is important to breathe deeply and cough as forcibly as possible to clear mucus from the lungs and reduce the risk for pneumonia.

Medications that may be used to treat pleurisy include over-the-counter or prescription pain relievers (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs]), prescription cough medicines, and antibiotics (i.e., to treat pleurisy caused by bacterial infection). If pleurisy is caused by congestive heart failure, diuretics may be prescribed.

In severe cases that do not respond to pain relievers, external splinting of the chest may help to reduce pain by limiting the expansion and contraction of the chest wall during breathing.

Thoracentesis may be performed to remove fluid, air, or blood from the pleural space. This procedure can help alleviate shortness of breath caused by pleural effusion, pneumothorax, or hemothorax, which often are associated with pleurisy.

If there is a large amount of pleural fluid, a chest tube may be necessary. In this procedure, a thin tube is inserted into the chest wall under local anesthesia. This tube is connected to a suction device, which is used to extract the fluid.

In severe cases that result in scarring of the pleural tissue, a procedure called decortication may be performed. This procedure, which is performed under anesthesia, involves using a thin scope to remove pus, scar tissue, and other debris from the pleural sac.

Rarely, complicated or advanced cases of pleurisy require open chest surgery to treat the condition. This procedure is called thoracotomy.

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