Nelson Textbook of Pediatrics 22nd Edition | Inflammation of the pleura without significant pleural effusion. Clinical: sharp, pleuritic chest pain (worse with deep breathing, coughing, sneezing), pleural friction rub on auscultation. Causes: viral infections (coxsackievirus, influenza, adenovirus, EBV), bacterial pneumonia (early stage), tuberculosis, pulmonary embolism, collagen vascular diseases (SLE, rheumatoid arthritis), uremia, post-cardiac injury syndrome, drug-induced. Diagnosis: clinical, CXR may be normal (or show minimal pleural thickening). Treatment: NSAIDs (ibuprofen), treat underlying cause. No drainage required. Prognosis: usually self-limited, resolves with treatment of underlying condition.
🌐 paeds.online — Pakistan's Pediatric Platform| Cause | Key Features | Treatment |
|---|---|---|
| Viral pleurisy | Prodrome of URI, self-limited, often with viral pneumonia (coxsackievirus, influenza, adenovirus) | NSAIDs, supportive care, treat underlying viral infection (if influenza, oseltamivir) |
| Bacterial pneumonia (early) | Fever, cough, focal findings on CXR, may progress to effusion | Antibiotics (for pneumonia), NSAIDs for pain |
| Pulmonary embolism | Sudden pleuritic chest pain, risk factors (DVT, surgery, oral contraceptives), +/- hemoptysis | Anticoagulation, treat underlying PE |
| SLE pleuritis | Pleuritic chest pain, fever, rash, arthritis, ANA/anti-dsDNA positive | NSAIDs, corticosteroids for severe, treat underlying SLE |
| Uremic pleuritis | Chronic kidney disease, dialysis patient, pleuritic pain, friction rub | Optimize dialysis, NSAIDs (caution with renal function) |