Diagnosis
The diagnosis of dry pleurisy is more difficult than that of the exudative form with exudate formation. The combination of clinical symptoms and the result of auscultation is indicative. During auscultation, i.e. listening with a stethoscope, a characteristic sound can be heard in dry pleurisy, which is called pleural rubbing in technical terminology.
Normally, the pleura does not make any sound during breathing. However, if you hear a creaking sound when breathing in and out (“leather creaking”), this is a clear indication of pleurisy. An x-ray of the rib cage is not yet diagnostically meaningful in dry pleurisy. Only in the case of exudative pleuritis can the effusions in the pleural gap and thickening of the pleura itself (pleural rind) be seen.
Symptoms
The main symptom of dry pleuritis is chest pain. Since it is an inflammation of the respiratory muscles, the pain is dependent on breathing, so it is particularly strong when breathing in and out. The pain character is described as severe and stabbing.
In addition, a irritable cough is sometimes described, but without the formation of sputum. In severe cases, the diseased side is pulled back during breathing or the breathing becomes shallower due to the pain. In addition there is usually a general exhaustion.
Depending on the underlying disease, the symptoms of the latter may also overlay those of pleurisy. When the dry form of pleurisy changes to the exudative form, the pain often passes because the pleural leaves no longer rub against each other but are separated by the exudate that is formed. However, this does not mean that the disease is dying out; on the contrary, it means that the inflammation is progressing and can make breathing more difficult.
Pleurisy without fever
Fever is not an obligatory symptom of dry pleurisy. The decisive factor in this case is the underlying disease. In the case of bacterial pneumonia that spreads to the pleura, for example, a fever must also be expected, since pneumonia itself would cause a fever. Infections with the Coxsackie B virus are also often accompanied by a slight fever.Depending on the cause, however, there are also cases of pleuritis without fever. Conversely, the absence of fever is not a criterion for the exclusion of pleurisy.
