Pleuritis

Question 1

A 43-yr. old female with no past medical history presents to your clinic complaining of localized sharp pain WORSE WITH COUGHING or DEEP BREATHS. On exam, the patient is breathing 16RR/min, shallow, and guarding chest against pain. What diagnosis
is HIGHEST on your differential?
A: Pleural effusion s/p pneumonia
B: Spontaneous pneumothorax
C: Pleuritis s/p viral infection
D: Simple rib fracture s/p fall

Answer 1

C: Pleuritis s/p viral infection

Answer: C (inflammation of the pleural lining that occurs in young healthy adults due to viral infection, pneumonia, or simple rib fracture)

Question 2

In this patient with pleuritis, what would be the most appropriate treatment recommendations?

Answer 2

Answer: Treat the underlying condition; administer pain medications (NSAIDs – reduce INFLAMMATION OF THE PLEURAL LINING; most often Indomethacin is used; control cough with codeine or other opioids)

Question 3

What complication occurs with pleuritis that requires immediate referral?

Answer 3

Answer: Large pleural effusion (REFER for diagnostic / therapeutic tx)