![]() ![]() Mediterranean spotted fever (caused by a rickettsial organism endemic to the Mediterranean region of Europe that triggers a syndrome similar to Rocky Mountain spotted fever in the United States), parapneumonic pleuritic pneumonia, tuberculosisĪdenovirus, coxsackieviruses, cytomegalovirus, Epstein-Barr virus, herpes zoster, influenza, mumps, parainfluenza, respiratory syncytial virusĪnkylosing spondylitis, collagen vascular diseases, familial Mediterranean fever, fibromyalgia, reactive eosinophilic pleuritis, rheumatoid arthritis, systemic lupus erythematosusĬhronic obstructive pulmonary disease, hemothorax, pleural adhesions, pneumothorax, pulmonary embolismĬhronic renal failure, renal capsular hematoma Malignancy, malignant pleural effusion, sickle cell crisisĪsbestosis, cardiothoracic surgery, medications, pericardiocentesis Inflammatory bowel disease, pancreatitis, spontaneous bacterial pleuritis In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.Īcute coronary syndrome, congestive heart failure, pericarditis, postcardiac injury syndrome, postmyocardial infarction syndrome, postpericardiotomy syndrome Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. Treatment is guided by the underlying diagnosis. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Viruses are common causative agents of pleuritic chest pain. Validated clinical decision rules are available to help exclude coronary artery disease. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. ![]()
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