Difference Between Pneumonia and Pleurisy

Main Difference – Pneumonia vs Pleurisy

Pneumonia and Pleurisy are two medical conditions which involve the respiratory system. The respiratory system consists of the nose, airway tracts and lungs. If any of these parts of the respiratory system is damaged, it can give rise to an impaired functional capacity of breathing and purification of air, resulting in a reduction of quality of life. The main difference between pneumonia and pleurisy is their etiology; pneumonia is caused by an inflammation of the lung tissue whereas pleurisy is caused by an inflammation of the thin membranes covering the lungs known as Pleura.

This article explains,

1. What is Pneumonia?
– Definition, Cause, Risk Factors, Signs and Symptoms, Diagnosis, Treatment

2. What is Pleurisy?
– Definition, Cause, Risk Factors, Signs and Symptoms, Diagnosis, Treatment

3. What is the difference between Pneumonia and Pleurisy?

What is Pneumonia

Pneumonia is defined as an inflammation of the lung tissue most often caused by a Pneumococcal infection. This can affect a single lung as well as both lungs depending on the distribution of the pathogenic organism.

Commonest bacterial organisms responsible for this pathology includes Streptococcus pneumonia, Haemophilus influenza, Legionella, mycoplasma pneumonia, etc.

Other rare types of pneumonia

Viral pneumonia – Respiratory syncytial virus (RSV), Influenza type A or B
Aspiration pneumonia – Caused by aspiration of vomitus, a foreign object (peanut. Smoke, fumes)
Fungal pneumonia – Experienced by immunosuppressed people.
Hospital-acquired pneumonia – Usually associated with an ICU setting due to ventilators.

Commonest risk factors for the development of pneumonia include extremities of age, chronic smoking, immune suppression due to HIV/AIDS, flu, Diabetes Mellitus, chemotherapy, etc. and various health conditions such as asthma, chronic lungs diseases, heart diseases, etc.

In healthy individuals, air which enters from the atmosphere into the lungs through airway tracts, get filtered by multiple tiny sacs present in the lungs known as alveoli. In this inflammatory condition, these sacs tend to get inflamed and collapse, resulting in an accumulation of fluid making it hard to function properly.

Lung signs and symptoms usually initiate 24-48 hours after the invasion of bacteria or progress gradually over days and most patients will experience a cough- dry or productive with thick yellow, green or blood-stained mucus, difficulty in breathing (rapid and shallow), breathlessness on exertion and even on resting, chest pain on breathing and exertion, tachycardia, fever with chills, fatigue, sweating, nausea, vomiting, wheezing, joint and muscle pain and loss of appetite. Rarely, elderly patients can experience confusion and fainting attacks.

It is important to seek immediate medical advice if any of these symptoms are noticed because untreated pneumonia can give rise to complications such as

Pleurisy – Inflammation of the pleura which can lead to respiratory failure
Lung abscess – In individuals with a serious pre-existing disease or a history of severe alcohol abuse
Septicemia – A serious complication where pathogenic organisms spread all through the blood circulation resulting in a dangerous systemic pathology.

Modes of diagnosis include,

Full blood count and blood culture
Chest X-rays
Ultrasound scan
Computerized tomography (CT) scan to identify possible complications.

Mild pneumonia can be treated at home by maintaining an adequate hydration, plenty of bed rest and consuming antibiotics. Most individuals will recover with proper medical interventions even though cough can last quite longer the other symptoms.

Since Pneumonia can easily transmit from one person to another through droplets (cough) it is necessary to keep the patient away from other members of the family.

At risk groups, mentioned above should be treated in a hospital setting to avoid life threatening complications to provide immediate treatments when necessary.

These patients should also be aware to maintain certain practices in order to prevent further spread of the disease to others around him, which include,

Covering the mouth and nose with a handkerchief when coughing or sneezing.
Throwing away the used tissues immediately.
Regular washing of hands to avoid the transfer of pathogens to other individuals.
Stop smoking
Stop alcohol misuse
People at high risk can get the pneumococcal vaccine which will effectively reduce the vulnerability to catch the infections.

What is Pleurisy

This is a condition which affects the thin membranes covering the lungs known as pleura. Major causative agents can either be pneumococcal infections or viral infections like the flu. Sometimes pulmonary embolism or lung malignancies can be a complication of this condition.

Individuals over 65 years of age or individuals with other immune suppressant conditions are at a high risk of getting affected by pleurisy.

Severe inflammation of these pleura can result in an impaired respiratory function associated with various clinical signs and symptoms such as,

Chest pain on deep breathing, coughing and sneezing
Dry cough
Shortness of breath
Coughing up blood
Nausea and vomiting

Diagnosis of pleurisy in clinically suspected individuals involves several blood investigations and imaging studies.

Full blood count and blood culture
Chest X-rays
Ultrasound scan
Computerized tomography (CT) scan
Lung biopsy – a tiny sample of pleura or lung tissue is removed to identify the exact pathology and complications.

Treatment of pleurisy mainly depends on the underlying etiology.

Pleurisy triggered by a viral infection will often resolve spontaneously with adequate bed rest and hydration whereas pleurisy caused by a bacterial infection should be intervened with antibiotics, depending on the causative agent.

Patients who do not respond to these initial treatments should be promptly admitted to hospital for further investigations.

Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen play a major role in relieving the chest pain associated with Pleurisy.

Cause

The major pathology behind pneumonia includes the inflammation of one or both lungs.

Pleurisy is caused by an inflammation of the thin membranes covering the lungs known as pleura.

Symptoms

As far as the symptoms are concerned, patients with pneumonia usually experience productive cough and fever.

Those with pleurisy will experience chest pain associated with deep breathing, coughing or sneezing on top of the other symptoms which are similar to pneumonia.

Recovery

Pleurisy doesn’t result in a quick recovery like pneumonia which is probably due to the formation of a scar tissue in lungs.

Furthermore, most patients with pneumonia, who are not responding to treatment have a high chance of ending up with pleurisy as a complication.

Both these conditions, if caused by a bacterial agent will be treated with Antibiotics like Penicillin.

Image Courtesy:

“Pleurisy and pneumothorax” By National Heart Lung and Blood Institute – National Heart Lung and Blood Institute (Public Domain) via Commons Wikimedia

“New Pneumonia cartoon” – The original uploader was InvictaHOG at English Wikipediaderivative work: Gambo7 (talk) – New_Pneumonia_cartoon.jpg (CC BY-SA 3.0) via Commons Wikimedia