Merck Manual

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Viral Pleuritis


Richard W. Light

, MD, Vanderbilt University Medical Center

Last full review/revision Jan 2021| Content last modified Jan 2021
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Viral pleuritis is a viral infection of the pleurae.

Viral pleuritis is most commonly caused by infection with coxsackie B virus. Occasionally, echovirus causes a rare condition known as epidemic pleurodynia (Bornholm pleurodynia), manifesting as pleuritis, fever, and chest muscle spasms. The condition occurs in the late summer and affects adolescents and young adults.

The primary symptom of viral pleuritis is pleuritic pain; pleural friction rub may be a sign.

Diagnosis is suspected in patients with pleuritic chest pain with or without systemic symptoms of viral infection. Chest x-ray is usually done. Other causes of pleuritic chest pain, such as pulmonary emboli and pneumonia, need to be considered and sometimes ruled out with testing.

Treatment is symptomatic with oral nonsteroidal anti-inflammatory drugs (NSAIDs) or a short course of oral opioids if needed.

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