The outcome of pleurisy treatment often depends upon the seriousness of the underlying disease. Often doctors examine pleural fluid under the microscope first to confirm any diagnosis. Then, treatment focuses on removing fluid, air, or blood from the pleural space, relieving symptoms, and treating the underlying condition. The goals of treatment are to:
Holding a pillow against the part of the chest that hurts while coughing or breathing deeply can be helpful. Wrapping the chest in wide, elastic bandages can help also help relieve severe pain, but this makes moving the chest during breathing more difficult and increases the risk of a collapsed lung or pneumonia. Other things that you can do at home include:
Pleurisy used to be a common complication of bacterial infections; since the use of antibiotics, however, rates have dropped substantially. If pleurisy is the result of a bacterial infection, doctors can prescribe antibiotics. If a virus is the underlying cause of pleurisy, no treatment will be given. Viral infections normally run their course without medications. If caused by lupus or an autoimmune disease, corticosteroids often quickly cure the pleurisy. For relief of pleurisy symptoms, your doctor may recommend:
Anti-inflammatory drugs - Acetaminophen or anti-inflammatory agent may be suggested to help control chest pain associated with pleurisy.
Analgesics - This class of drugs are also used to treat the pain of pleurisy.
Antibiotics - If the pleural fluid is infected with bacteria, treatment involves antibiotics and draining the fluid.
Anti fungals - Treatment for pleurisy often involves long-term use antifungal medicines for cases of infection from a fungus.
Anti tumor medicines - If the fluid is caused by tumors of the pleura, it may build up again quickly after it's drained and can be lessened with the use of anti tumor medications. This is why chemotherapy or radiation treatment may be used to reduce the size of the tumors.
Cough syrups - Codeine-based cough syrups may be prescribed to control a painful cough caused by pleurisy. However, coughing is an important reflex which keeps the lungs from collapsing and prevents pneumonia, so may not be a viable option.
Steroid treatment - If the cause is due to an autoimmune disease such as lupus, steroid treatment can help quickly relieve pain related to pleural disorders.
I Medical procedures used to drain fluid, air, or blood from the pleural space are similar. This is because large amounts of fluid, air, or blood can put pressure on the lung and cause it to collapse. Sometimes the fluid contains pus that is very thick or blood clots. Or it may have formed a hard skin or peel. This makes it harder to drain the fluid. To help break up the pus or blood clots, doctors use chest tubes to administer medicines into the pleural space. These medicines are called fibrinolytics. If the pus or blood clots still don't drain out, you may need surgery. Procedures used to treat pleurisy include:
Chest tube - Doctors may insert a chest tube through the chest wall when larger amounts of fluid must be removed. The tube is connected to a box that suctions the fluid out. A chest tube also is used to drain blood and air from the pleural space.
Pleurodesis - During a pleurodesis, your doctor seals the pleural space. After draining all the fluid out of the chest through a chest tube, doctors insert a substance through the tube to irritate the surface of the pleura. The manual irritation causes the two layers of the pleura to squeeze shut so there is no room for more fluid to build up.
Thoracentesis - During thoracentesis, the doctor inserts a needle or a thin, hollow, plastic tube through the ribs in the back of the chest into the chest wall and draws fluid out of the chest.
To help reduce chances of developing pleurisy, seek early medical attention for conditions that can cause pleurisy. Also, consider getting vaccinated for pneumonia, especially if you are older, have a chronic illness, or weakened immunity.