Pleurisy (Pleuritis)

ICD-9: 511.0


Pleurisy is inflammation of the visceral (inner) and parietal (outer) pleural membranes that envelop each lung. The saclike membrane enveloping each lung and lining the adjacent portion of the thoracic cavity or the pleura of one or both lungs may be affected. The two layers are lubricated with pleural fluid. The condition may be either primary or secondary and is often associated with pleural effusion.


Primary pleurisy is caused by infection of the pleura by bacteria, fungus, parasites, or viruses. It can be the result of inhaled toxins or chemical fumes. The condition is often secondary to pneumonia, heart failure, pulmonary infarction, neoplasm, systemic lupus erythematosus, pulmonary embolism, and chest trauma.


Signs and Symptoms

The lung’s pain fibers are located in the pleura, so when the tissue becomes inflamed, the sharp stabbing pain can be so severe that it limits movement on the affected side when breathing. Clients often believe they are having a heart attack. Other symptoms may include coughing, fever and chills, and chest pain that is greater during inspiration. Dyspnea also may occur.

Diagnostic Procedures

Chest auscultation reveals a pleural friction rub (“squeaky leather” or grating sound) during respiration. Additional information can be obtained from a chest x-ray, ultrasound, and CT scan if necessary.


Treatment is aimed at the underlying cause but is otherwise symptomatic. Such treatment may include the use of strong analgesics and antiinflammatory agents. Bed rest is usually indicated.


Thoracentesis (removing chest fluid) can relieve the pain and shortness of breath, but caution should be exercised because it can temporarily worsen the pleurisy if the two inflamed pleural surfaces rub directly on each other.

Complementary Therapy

Treatment of the underlying cause is essential, along with natural analgesics and anti-inflammatory agents.


Stress the importance of bed rest, and encourage clients to apply firm pressure at the site of the pain during coughing to minimize pain.


Prognosis is dependent on etiology but is usually good. Pleural effusion, a collection of fluid in the pleural space, may develop.


Early treatment of any respiratory diseases is the best prevention.

READ:   Pulmonary embolism
Pleural effusion ICD-9: 511.9 Description Pleural effusion is an excess of fluid between the parietal and visceral pleural membranes enveloping each lung. The accumulating fluid may be characterized as transudate, which has little or no protein, or exudate, which is rich in protein. Etiology Pleural effusion may occur regardless of whether there is a pathological process affecting the pleurae themselves. Transudative pleural effusions frequently result from congestive heart failure, hepatic disease with ascites, and peritoneal dialysis. Exudative pleural effusions more often are seen with inflammation of the pleura, TB, rheumatoid arthritis, pancreatitis, respiratory neoplasms, and bacterial pneumonia. Signs and Symptoms The person may be asymptomatic. When signs and symptoms are manifested, they may include cough, dyspnea, and chest or pleuritic pain. The symptoms of pleural effusion will typically accompany those of any underlying condition. Diagnostic Procedures Auscultation of...
Acute tonsillitis ICD-9: 463 Description Acute tonsillitis is inflammation of a tonsil, especially one or both of the palatine tonsils that lie on either side of the opening of the throat. It can be acute or chronic. Etiology Tonsillitis is most frequently caused by infection by the bacteria Streptococcus pyogenes or Staphylococcus aureus, although a variety of infectious agents may be involved. The condition is a common complication of pharyngitis. Signs and Symptoms Acute tonsillitis is typically manifested by the sudden onset of chills and a high-grade fever with a mild to severe sore throat. Additional symptoms may include malaise, headache, and dysphagia. Chronic tonsillitis causes a recurrent sore throat, tonsillar hypertrophy, and abscess. Diagnostic Procedures On physical examination, the tonsils appear red and swollen. In severe cases, abscesses may be visible on the affected tonsil’s surface. Blood tests may reveal leukocytosis. A throat culture to detect bacteria typical...
Pulmonary embolism ICD-9: 416.2 Description A pulmonary embolism is a mass of undissolved matter in the pulmonary artery or one of its branches. It is the most common pulmonary complication among hospitalized individuals with about 250,000 incident cases occurring annually. It is not considered a disease itself but is a complication of venous thrombosis. It is potentially lethal. Etiology FIGURE. Embolism. (From Thomas, CL : Taber’s Cyclopedic Medical Dictionary, ed 21. FA Davis, Philadelphia, 2005, p 744, with permission.) A pulmonary embolism generally originates in the pelvic veins or deep lower extremity veins and travels through the circulatory system until it blocks a pulmonary artery. At high risk for pulmonary emboli are individuals immobilized with chronic diseases, those in body casts, persons with congestive heart failure or neoplasms, and postoperative clients. Also at risk are pregnant women; women taking oral contraceptives; and individuals with venous diseases, such as var...
Understanding ARDS Acute respiratory distress syndrome (ARDS) is sudden, life-threatening lung failure. ARDS occurs when the alveoli become inflamed and filled with liquid, causing their collapse. Gas exchange ceases, and the body is starved for oxygen. ARDS is a syndrome rather than a disease. It most often occurs within 24 to 48 hours of injury or illness, and the intensity and duration varies from one person to another. The mortality rate ranges from 35% to 50%, in most cases as a result of underlying disease or mechanical ventilation complications.
Pulmonary tuberculosis ICD-9: 011.xx REPORTABLE DISEASE Description Pulmonary tuberculosis (TB) is a slowly developing bacterial lung infection characterized by progressive necrosis of lung tissue. An inflammatory response begins with phagocytosis. Growths of inflamed, granular-appearing tissue (granulomas) form and, when they calcify, leave lesions that may be visible on an x-ray. The lymph and blood generally are affected. Pulmonary TB is a common cause of death in the world. The arrival of nearly 400,000 immigrants and over 50,000 refugees per year from overseas contributes to the rise of TB in the United States. The incidence of TB also is increasing due to homelessness, substance abuse, and HIV infection - all related to individuals who are less likely to receive adequate medical attention. In general, TB is more common among elderly persons, the urban poor, and members of minority groups. Etiology Pulmonary TB is caused by Mycobacterium tuberculosis. The infected individual’s immune sys...