Pleurisy is inflammation of the pleura, the thin layers of tissue that cover the lungs and line the inside of the chest. The typical symptom is sharp chest pain that becomes worse when you breathe deeply, cough or sneeze. Pleurisy is not a diagnosis of the underlying problem, so the cause of new pleuritic chest pain should be assessed.
Symptoms
- Sharp or stabbing chest pain, often on one side
- Pain that worsens with deep breathing, coughing, sneezing or chest movement
- Pain that may spread to the shoulder or back
- Cough, fever or shortness of breath when an infection or another lung condition is present
Fluid can sometimes build up between the pleural layers. This is called a pleural effusion and may cause increasing shortness of breath.
Causes
Pleurisy can occur with viral infections, pneumonia, tuberculosis, chest injury and autoimmune diseases such as rheumatoid arthritis or lupus. More serious causes include pulmonary embolism and some cancers.
Diagnosis
A healthcare professional may listen to the chest and assess breathing, heart rate, temperature and oxygen level. Depending on the symptoms, tests can include blood tests, an ECG, chest X-ray, ultrasound or CT scan. If a pleural effusion is present, a sample of fluid may sometimes be removed for testing.
Treatment
Treatment depends on the cause. Viral infections often improve with supportive care. Bacterial infections may require antibiotics. A pulmonary embolism, significant pleural effusion or another serious underlying condition requires specific treatment.
Pain relief may be helpful when medically appropriate. People with kidney disease, stomach ulcers, cardiovascular disease, pregnancy, anticoagulant treatment or other medical conditions should check which pain medicines are suitable for them.
When to seek urgent help
Seek emergency medical care for severe or rapidly worsening breathing difficulty, blue or gray lips or skin, collapse, coughing up blood, severe chest pressure, or sudden chest pain accompanied by marked shortness of breath or fainting. Use your local emergency medical service when symptoms are severe or life-threatening.
New sharp chest pain that worsens with breathing or coughing should be medically assessed, particularly when accompanied by fever, persistent cough or shortness of breath.
Related topics
Sources and further reading
Last reviewed: 4 September 2026.