The treatment of pleurisy depends on its underlying cause:
Lung infection — Pleurisy caused by bacterial pneumonia is treated with antibiotics. Pulmonary tuberculosis is treated with antituberculosis drugs. Because pleurodynia is a viral infection, it does not respond to antibiotic treatment. However, most people with pleurodynia recover on their own without complications. When there is a large pleural effusion, the doctor may drain the accumulated fluid, allowing the patient to breathe more comfortably and efficiently. Pain medication also can improve the patient's ability to breathe, because it relieves chest discomfort. In some patients, oxygen therapy also is necessary.
Pulmonary embolism — A small pulmonary embolism can be treated with anticoagulants, drugs that thin the blood and prevent future blood clots. Large pulmonary emboli may be treated with thrombolytic medications, drugs that dissolve blood clots.
Lung cancer — Treatments include surgical removal of all or part of a lung, radiation and chemotherapy.
Rheumatic fever — Rheumatic fever is treated with antibiotics (usually penicillin) to kill strep bacteria, together with aspirin or other anti-inflammatory drugs to reduce inflammation. Additional treatments may be needed for people with severe cardiac or neurological symptoms.
Connective tissue disorders — The pleurisy of lupus can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen (Advil, Motrin), or with corticosteroids, such as prednisone (sold under several brand names), hydrocortisone (Cortef, Hydrocortone), methylprednisolone or dexamethasone (both sold under several brand names). Medications that suppress the immune system to control the underlying connective tissue disease will often help to control the pleural inflammation.