Pleurisy is caused by what?

Written by An Yong Peng
Pulmonology
Updated on February 11, 2025
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Pleurisy is often caused by various pathogens, such as viral infections, which can lead to pleurisy termed viral pleurisy. Viral pleurisy typically presents with noticeable chest pain, and may even be accompanied by tenderness in the chest wall. Similarly, bacterial infections can also cause pleurisy. If the infection is a purulent bacterial infection, it is known as purulent pleurisy. Generally, those with purulent pleurisy experience high fever symptoms. Another common cause of pleurisy is tuberculosis infection, known as tuberculous pleurisy. Typical symptoms of tuberculous pleurisy include low-grade fever in the afternoon, night sweats, and may also include chest tightness and chest pain.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Pleurisy often presents with symptoms of chest pain, which tends to worsen with deep breathing. Patients with pleurisy may also experience a feeling of tightness in the chest, possibly caused by a significant accumulation of fluid in the chest cavity due to the pleurisy. Sometimes, this tightness could also be due to severe chest pain that makes the patient reluctant to inhale deeply. Patients with pleurisy are likely to exhibit symptoms of fever. It is important to note that pleurisy caused by different factors may have distinct clinical features. For example, purulent pleurisy often presents with high fever, while tuberculous pleurisy may show symptoms of tuberculosis intoxication like low-grade fever in the afternoon and night sweats. However, some cases of tuberculous pleurisy might present with high fever, and others may not have noticeable fever at all. Additionally, viral pleurisy usually features prominently painful symptoms in the chest.

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Written by Luo Peng
Thoracic Surgery
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Can you exercise with pleurisy?

Whether or not a patient with pleurisy can exercise should be determined based on the individual's specific condition. For mild pleurisy without pleural effusion and severe pain, exercise is permissible. However, if pleural effusion is present, it should be drained or aspirated first, after which exercise can be encouraged. Exercise should be moderate, as it can help absorb the pleural effusion, which is beneficial for the patient. Additionally, if pleurisy causes severe pain, it is best to minimize movement to avoid exacerbating the pain.

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Written by Wang Chun Mei
Pulmonology
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Does pleural calcification easily turn into cancer?

Pleurisy is a very common type of inflammatory lesion clinically. There are many factors that cause pleurisy, and it is generally seen in young and middle-aged males, mainly caused by Mycobacterium tuberculosis infection of the pleural cavity. If the pleurisy is tuberculous, it is usually treated with effective anti-tuberculosis medications systematically, which typically requires a course of 6 to 9 months. After complete recovery from pleurisy, many patients may show varying degrees of calcification spots in the pleural cavity. Generally, these calcification spots after recovery from pleurisy do not easily become cancerous.

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Written by Shen Jiang Chao
Radiology
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Pleural inflammation CT manifestations

The causes of pleurisy mainly include tuberculous, purulent, bacterial, tumorous, traumatic, and rheumatic types, with the tuberculous type being the most common. Pleurisy is predominantly characterized by pleural effusion, which generally looks similar on a CT scan. CT scans cannot distinguish the cause of pleurisy. A small amount of pleurisy manifests as a minor amount of free effusion, appearing as an arc or crescent of uniform density along the posterior chest wall. As the effusion gradually increases to a moderate or large amount, it can compress lung tissue, leading to compressive atelectasis. In cases of large volume effusion, aside from causing atelectasis, it can also significantly push the mediastinum towards the healthy side.

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Written by Wu Xiao Sheng
Pulmonology
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Is tuberculous pleurisy contagious?

Tuberculous pleurisy generally does not transmit. Tuberculous pleurisy is a special clinical type of tuberculosis, caused by the proliferation of Mycobacterium tuberculosis on the pleura. Tuberculous pleurisy can cause symptoms such as afternoon low fever, night sweats, weight loss, and even chest tightness and shortness of breath. However, since tuberculous pleurisy is not open tuberculosis, it does not release the tuberculosis bacteria into the environment, and thus lacks a definitive transmission route. Hence, tuberculous pleurisy is mostly not contagious to others. Although tuberculous pleurisy is an infectious disease, its infectivity is extremely low.