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What Causes Pleurisy and Other Pleural Disorders?


Many conditions can cause pleurisy. Viral infections are likely the most common cause. Other causes of pleurisy include:

  • Bacterial infections, such as pneumonia (nu-MO-ne-ah) and tuberculosis, and infections from fungi or parasites
  • Pulmonary embolism, a blood clot that travels through the blood vessels to the lungs
  • Autoimmune disorders, such as lupus and rheumatoid arthritis
  • Cancer, such as lung cancer, lymphoma, and mesothelioma (MEZ-o-thee-lee-O-ma)
  • Chest and heart surgery, especially coronary artery bypass grafting
  • Lung diseases, such as LAM (lymphangioleiomyomatosis) or asbestosis (as-bes-TO-sis)
  • Inflammatory bowel disease
  • Familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or lungs

Other causes of pleurisy include chest injuries, pancreatitis (an inflamed pancreas), and reactions to certain medicines. Reactions to certain medicines can cause a condition similar to lupus. These medicines include procainamide, hydralazine, and isoniazid.

Sometimes doctors can't find the cause of pleurisy.


Lung diseases or acute lung injury can make it more likely that you will develop a pneumothorax (a buildup of air or gas in the pleural space). Such lung diseases may include COPD (chronic obstructive pulmonary disease), tuberculosis, and LAM.

Surgery or a chest injury also may cause a pneumothorax.

You can develop a pneumothorax without having a recognized lung disease or chest injury. This is called a spontaneous pneumothorax. Smoking increases your risk of spontaneous pneumothorax. Having a family history of the condition also increases your risk.

Pleural Effusion

The most common cause of a pleural effusion (a buildup of fluid in the pleural space) is heart failure. Lung cancer, LAM, pneumonia, tuberculosis, and other lung infections also can lead to a pleural effusion.

Sometimes kidney or liver disease can cause fluid to build up in the pleural space. Asbestosis, sarcoidosis (sar-koy-DO-sis), and reactions to some medicines also can lead to a pleural effusion.


An injury to the chest, chest or heart surgery, or lung or pleural cancer can cause a hemothorax (buildup of blood in the pleural space).

A hemothorax also can be a complication of an infection (for example, pneumonia), tuberculosis, or a spontaneous pneumothorax.

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Last Updated: September 21, 2011