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    Pleurisy is inflammation of the sheet-like layers that cover the lungs (the pleura).

    The most common symptom of pleurisy is a sharp chest pain when breathing deeply. Sometimes the pain is also felt in the shoulder.
    The pain may be worse when you cough, sneeze or move around, and it may be relieved by taking shallow breaths.
    Other symptoms can include shortness of breath and a dry cough.

    Seek immediate medical help if your chest pain is severe, particularly if you also have other symptoms, such as coughing up blood, nausea or sweating.

    Pleurisy can usually be diagnosed by studying your symptoms. Your doctor can listen to your chest to check for the distinctive dry, crunching sound that suggests you may have pleurisy.

    Further tests may be needed to identify the underlying cause of your pleurisy and to assess how severe it is. These can include:
    blood tests to determine whether you have an infection or an autoimmune condition

    chest X-rays
    an ultrasound scan
    a computerised tomography (CT) scan
    a biopsy – a small sample of pleural or lung tissue is removed for further testing

    What causes pleurisy?
    Most cases are the result of a viral infection (such as the flu) or a bacterial infection (such as pneumonia).

    In rarer cases, pleurisy can be caused by conditions such as a blood clot blocking the flow of blood into the lungs (pulmonary embolism) or lung cancer.

    Pleurisy can affect people of all ages, but people of 65 years and over are most at risk, because they’re more likely to develop a chest infection.

    How is pleurisy treated?
    Treatment for pleurisy depends on the underlying cause.
    For example, pleurisy caused by a viral infection will often resolve itself without treatment.
    However, pleurisy caused by a bacterial infection is usually treated with antibiotics, and people who are frail or already in poor health may be admitted to hospital.

    Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often used to relieve the chest pain associated with pleurisy.

    If excess fluid builds up between the pleural layers, it may be necessary to drain the fluid to prevent breathing difficulties.

    G Mohan.

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