Causes and Diagnoses

Causes and Diagnoses of Pleurisy and Pleural Effusion

The causes of pleurisy and pleural effusion differ, although pleurisy can sometimes lead to pleural effusion.

Causes of pleurisy include:

Viral infection
Bacterial infection
Fungal infection
Certain medications
Pulmonary embolism (blood clot in the lungs)
Rib fracture
Autoimmune diseases, such as rheumatoid arthritis and lupus
Sickle cell disease
Lung cancer
Heart conditions, including a heart attack or pericarditis (inflammation of the membrane surrounding the heart)

Causes of pleural effusion include:

A diagnosis of pleurisy or pleural effusion begins with a discussion of your symptoms and a physical exam. Tests may include:

X-ray: A chest X-ray can identify the presence of blockages or fluids creating pressure.
Computed tomography (CT) scan: This test combines X-ray and computer technology to produce detailed cross-sectional images of your chest cavity.
Ultrasound: This type of imaging captures movement to detect the location of the fluid or inflammation and its impact on the lung movement.
Electrocardiogram (EKG): This heart-monitoring test may be used to determine if a heart condition is causing the effusion or pleurisy.
Thoracentesis: This is a process of removing a sample of the fluid in the pleura for analysis in a lab. The fluid will be checked for infection, cancer and protein levels.
Thoracoscopy: In this surgical procedure, an endoscope (thin, flexible tube with a camera on the end) is inserted in a small incision in your chest to take a closer look at what might be causing the effusion or to take a biopsy (tissue sample).