Causes

Inflammation of the pleura is not itself considered an independent disease. In most cases, the inflammatory processes occur in the course of other underlying diseases that affect the pleura. The main cause of inflammation of the pleura is pneumonia (technical term: pneumonia).

In this disease, pronounced inflammatory processes occur within the lung tissue which can spread to the pleura. In addition, tuberculosis is one of the typical diseases that are usually accompanied by inflammation of the pleura. Tuberculosis is a chronic infectious disease that mainly affects the lungs.

The cause of this disease is an infection with immobile, acid-stable bacteria (Mycobakerium tuberculosis). The infection usually occurs through direct contact with persons suffering from open tuberculosis. At the beginning of the infection, the affected patients typically develop unspecific disease symptoms such as coughing, night sweats and loss of appetite.

In addition, the infected persons experience a slight rise in temperature shortly after infection. In the further course of the disease, an inflammation of the pleura with pronounced fluid retention, impairment of the liver and spleen, and the onset of meningitis can occur. Tuberculosis is a serious disease that requires urgent treatment.

A further cause for the development of an inflammation of the pleura is the so-called “lung infarction” (death of lung tissue as a result of vascular occlusion). If an inflammation of the pleura is present, cancerous diseases (e.g. a bronchial carcinoma or a pleural mesothelioma) should also be excluded. Especially pleural mesothelioma, which can lead to inflammation of the pleura, occurs mainly in people exposed to asbestos at work.

Furthermore, inflammation of the pleura can be caused by various autoimmune diseases.A classic example of such a disease is lupus erythematosus. In rare cases, the inflammation of the pleura is caused by an acute viral infection. Especially the Coxsackie-B virus or the herpes virus are possible pathogens.

The symptoms caused by an inflammation of the pleura depend largely on the type of disease present in the patient. In this context, the question whether the inflammation of the pleura is accompanied by pleural effusion plays a decisive role. Symptoms of dry inflammation of the costal pleura If the affected patient experiences severe stabbing pain in the region of the ribcage, it can be assumed that it is a dry inflammation of the costal pleura.

Typically, the pain increases significantly in intensity during inhalation and coughing. For this reason, the affected persons usually show very shallow breathing. In addition, an irritable cough without sputum is one of the most common symptoms of dry inflammation of the pleura.

During the physical examination, a typical pleural rubbing can also be heard with the stethoscope. These rubbing noises are caused by the sliding of the individual layers of the inflamed pleura over each other. Since even in the dry form of the inflammation there can be minimal fluid accumulation at the pleura, these typical signs usually disappear during the course of the disease.

Symptoms of the wet inflammation of the pleura In contrast to the dry inflammation of the pleura, the wet form of the disease does not cause painful symptoms in the area of the ribcage. The reason for the fact that no pain is felt in the case of the wet inflammation of the pleura is the fact that there is an accumulation of fluid between the pleura and the lung. Typical symptoms of the wet inflammation of the pleura are a feeling of pressure in the chest and pronounced difficulty in breathing.

In rare cases, the wet form of the inflammation of the pleura causes initial pain in the shoulder area. The reason for this is an irritation of the diaphragmatic nerve (nervus phrenicus) caused by the accumulation of fluid. In addition, the wet inflammation of the pleura can be distinguished from the dry form by other symptoms. Above all, the weight gain caused by the accumulation of fluid between the pleura and the lungs is a decisive differentiating factor. In addition, wet pleuritis usually leads to high fever, while patients suffering from dry inflammation of the pleura usually show only a slight increase in temperature.