What is pleurisy? | What are the causes of pleurisy?

Pleural effusion refers to fluid accumulation in the pleura, the membrane surrounding the lungs. In a healthy individual, the lungs are covered by two different membrane layers: the parietal pleura on the outside and the visceral pleura on the inner wall. The slippery fluid between these membranes allows the lungs to inflate and deflate smoothly during breathing. This fluid is secreted by the outer lung membrane and is absorbed by the inner membrane covering the lungs. The approximate volume is 20 ml. The space between the two membranes, called the pleural cavity, is in constant movement, and the fluid level remains stable. Some lung diseases can cause this fluid to increase or prevent its absorption. As a result, the amount of fluid increases.

What causes pleural effusion?

The commonly seen causes of pleural effusion, defined as an increase in the amount of fluid between the membrane layers surrounding the chest wall and lungs, may include lung cancer, pleural cancer, lung abscess, tuberculosis, and pulmonary embolism. Pneumonia, defined as inflammation of lung tissue caused by bacteria and viruses, is also an important lung disease that causes pleural effusion. Many of the conditions causing this increase in fluid volume are listed below:

• Viral and bacterial infections
• Fungal infections
• Inflammation developing in the pancreas
• Edema developing in the lungs
• Failure of part of the lung to inflate during breathing
• Heart failure
• Increased pressure in the artery extending to the lungs
• Kidney and liver disorders
• Complications occurring after heart surgery
• Rib fractures
• Lymphoma and esophageal cancer
• Cirrhosis
• Rheumatoid arthritis
• Thyroid disease
• Familial Mediterranean fever (FMF)
• Trauma
• Side effects that may be caused by certain medications

What are the symptoms of pleural effusion?

In pleural effusion disease, complaints such as cough and chest pain are in the foreground. Due to pain of moderate to severe intensity, breathing becomes difficult. Because of the shortness of breath felt, the person does not want to lie on their back. Fever, chills, sweating, shivering, fatigue, and loss of appetite are among other symptoms encountered. As the disease progresses, the existing dry cough may be replaced by a much more severe and body-wracking cough. With each cough, it feels as though a knife is being driven into the back. In some cases, this pain can be felt extending to the shoulder and abdominal regions.

How is pleural effusion treated?

Following the diagnosis by a chest diseases specialist, the condition causing the pleural effusion is also identified. This is because the treatment applied for pleural effusion varies depending on the underlying cause. For example:

• If pleural effusion caused by bacterial infections is involved, anti-inflammatory medications are prescribed to treat and reduce complaints.
• If the cause is tuberculosis, long-term antibiotic therapy is applied.
• If heart failure is involved, the use of diuretic medications is recommended.
• In the case of pleural cancer, surgical operation removes the tissue located outside the lung that is responsible for fluid consumption.
• In some cases, drainage is performed and the fluid in the pleura can be emptied.