Pneumonia complicated by inflammation of the outer lung sac, or pleura, is called pleuritic pneumonia. The usual symptoms of pneumonia occur with this condition, accompanied by additional symptoms arising from inflammation of the pleura. Fluid accumulation around the lungs often arises with pleuritic pneumonia. Bacteria, viruses or fungi can cause pleuritic pneumonia. Treatment focuses on antimicrobial medication to treat the infection and pain management.
Painful Cough
Patients with pleuritic pneumonia typically have a wet-sounding cough. Pleural involvement causes sharp, stabbing pain when the affected area rubs against the chest wall. Coughing, therefore, typically causes severe, localized pain, notes "The Merck Manual for Healthcare Professionals." Patients can generally point to a specific area of the chest, which reflects the area of the inflamed pleura. To prevent pain, patients with pleuritic pneumonia often try to suppress coughing and brace the chest when they cannot suppress a cough.
Shallow Breathing
Deep breathing causes rubbing of the pleura against the chest wall, provoking pain in those with pleuritic pneumonia, reports the National Library of Medicine encyclopedia MedlinePlus. To prevent pain, patients often resort to shallow breathing. This pattern of breathing can contribute to shortness of breath often experienced with pneumonia.
Self-Imposed Movement Limitation
Any significant movement can trigger the sharp pain of pleuritic pneumonia, notes MayoClinic.com. Patients, therefore, often display limited and careful movement as they try to avoid any activity that might cause pain. As such, when a patient with pleuritic pneumonia has to move, he may press on the painful area because it decreases the level of pain evoked.
Shortness of Breath
Shortness of breath can occur with any type of pneumonia. Those with pleuritic pneumonia, however, may develop an accumulation of fluid around the infected lung, a condition known as a pleural effusion, as noted on the medical information website InteliHealth. A large-volume pleural effusion may limit the expansion of the lung, contributing to shortness of breath. In cases of severe pleuritic pneumonia affecting a large area of one or both lungs, shortness of breath may be accompanied by a bluish discoloration around the lips, indicating insufficient oxygen in the bloodstream.
Fatigue and Muscle Aches
Fatigue and muscle aches often occur with pneumonia. In a May 2007 article published in "American Family Physician," Dr. Sara Kass and colleagues point out that the presence of these symptoms can help distinguish pleuritic pneumonia from other possible causes of pleuritic chest pain, such as a blood clot in the lung, a heart attack and inflammation of the sac surrounding the heart.
