Quick answer. Pleurisy is inflammation of the lining around the lungs that causes a sharp chest pain, worse when you breathe in or cough. It is often due to a viral infection and settles with treatment of the cause plus pain relief, but sudden severe breathlessness can signal a more serious problem.
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Pleurisy is inflammation of the pleura, the thin double layer of tissue that lines the lungs and the inside of the chest wall. When these layers become inflamed, they rub against each other instead of gliding smoothly, producing a characteristic sharp chest pain that gets worse when you breathe in deeply, cough or sneeze. In Singapore, pleurisy is most often caused by a viral chest infection.
While many cases of pleurisy are due to a self-limiting viral illness, the same chest pain can sometimes point to something more serious, such as pneumonia or, rarely, a blood clot on the lung. This guide explains the causes, how doctors tell them apart, how pleurisy is treated, and the warning signs that mean you should seek urgent help.
At a glance
| Cause | Typical picture | General approach |
|---|---|---|
| Viral infection | Recent cold or flu, otherwise well | Often self-limiting; pain relief and rest |
| Pneumonia | Fever, productive cough, feeling unwell | Antibiotics for the infection |
| Blood clot on the lung (PE) | Sudden breathlessness, fast heart rate | Medical emergency – needs urgent assessment |
| Autoimmune conditions | Joint pains, other symptoms over time | Treat the underlying condition |
| Chest injury | Recent trauma to the ribs or chest | Pain control and review |
What is pleurisy?
Pleurisy, sometimes called pleuritis, is inflammation of the pleura – the two thin layers of tissue that separate your lungs from your chest wall. Normally a small amount of fluid lets these layers slide over each other smoothly as you breathe. When they become inflamed, the surfaces rub together, which causes a sharp, stabbing chest pain that is worse with breathing and coughing.
Pleurisy is a symptom of an underlying problem rather than a disease in itself. In Singapore, the most common cause is a viral infection of the chest, which usually settles on its own. Anyone can develop pleurisy, but the right treatment depends entirely on finding and treating the cause behind the inflammation.
Symptoms & signs
The hallmark of pleurisy is a sharp chest pain linked to breathing. Symptoms may include:
- Sharp, stabbing chest pain that is worse when you breathe in deeply, cough, sneeze or move
- Pain that may be felt in one area of the chest, the shoulder or the back
- Shallow, rapid breathing to avoid triggering the pain
- A dry cough
- Fever or feeling generally unwell, if an infection is the cause
Some people also build up fluid between the pleural layers (a pleural effusion), which can ease the sharp pain but may cause breathlessness instead.
Causes & risk factors
Pleurisy can have several causes, and identifying which one is present is the key to treatment. Causes include:
- Viral infections – the most common cause, such as after a cold or flu
- Pneumonia or other bacterial chest infections
- A blood clot on the lung (pulmonary embolism) – less common but serious
- Autoimmune conditions, such as lupus or rheumatoid arthritis
- Chest injury or rib fractures
- Rarely, problems such as tuberculosis or, very occasionally, cancer affecting the pleura
Risk factors relate mainly to the underlying cause – for example, recent infection, immobility or a long flight (which raise clot risk), or a known autoimmune condition.
How pleurisy is diagnosed
A doctor will ask about your symptoms and listen to your chest, sometimes hearing a characteristic rubbing sound (a pleural rub). Because the causes range from harmless to serious, tests are often used to find the reason and rule out dangerous conditions:
- Chest X-ray – to look for pneumonia, fluid or other lung problems
- Blood tests – to check for infection or inflammation
- CT scan – particularly a CT pulmonary angiogram if a blood clot is suspected
- ECG – to help exclude heart-related causes of chest pain
- Sampling pleural fluid, if a significant effusion is present
The most important early step is to decide whether the cause is a simple viral illness or something that needs urgent treatment.
Treatment options
Treatment of pleurisy has two parts: relieving the pain and treating the underlying cause. Options include:
- Pain relief – anti-inflammatory painkillers (NSAIDs) are often very effective at easing pleuritic pain; other painkillers may be used if needed
- Treating the cause – antibiotics for bacterial pneumonia, blood-thinning medication for a clot, or treatment of an autoimmune condition
- Rest and time – viral pleurisy often settles over days to a couple of weeks
- Draining fluid – if a large pleural effusion causes breathlessness, fluid may be drained
Because pleurisy from a viral infection usually needs no prices or procedures, there are no costs to quote here; care is mainly medication and follow-up. Your doctor will tailor treatment to the specific cause.
When to see a doctor & which specialist
See a doctor if you develop a new sharp chest pain that is worse on breathing, especially with fever, cough or feeling unwell, so the cause can be found and treated.
Some features are red flags for a serious cause such as a blood clot on the lung. Call 995 or go to A&E immediately if you have sudden or severe breathlessness, chest pain with a fast heart rate, coughing up blood, light-headedness or fainting, or a one-sided leg swelling alongside chest pain. These can signal a pulmonary embolism or another emergency and need immediate assessment – do not wait.
For non-urgent pleurisy or ongoing chest symptoms, a respiratory physician can investigate and manage the underlying cause. You can find one through our directory of the best respiratory physicians in Singapore.
Related guides
- Best Respiratory & Lung Clinics in Singapore — our editorial shortlist
- Adenomyosis
- Bronchoscopy
- Laminectomy
- De Quervain's
- Dupuytren's
Sources
- NHS – Pleurisy
- Mayo Clinic – Pleurisy
- HealthHub Singapore – Lung Health
- SingHealth – Respiratory conditions
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