Symptoms Make an Appointment Refer a Patient Ask a Question Reviewed by Ellen Volker, MD, MSPH (May 01, 2019) Some people do not notice any symptoms of pleural effusion. Pleural effusion is often discovered during a different medical procedure or test. This is because the fluid that builds up prevents the layers of pleura from rubbing against each other. That rubbing is the main cause of discomfort. People who do experience symptoms may notice one or more of the following: Chest pain Fever Chills Cough Difficulty breathing, especially when reclined or laying down Shortness of breath Hiccups Weight loss If fluid continues to collect in and around the lungs, it causes extra pressure which can make the lungs partially or fully collapse. Fever can occur if the pleural fluid becomes infected and turns into a pus called empyema. Symptoms of pleurisy are often more intense. The two layers of pleura rub directly against each other, causing irritation. Common symptoms of pleurisy include: Sharp pain in the chest that worsens when you breathe, cough or sneeze Dull ache in the chest that may radiate into the shoulders or back Difficulty breathing Shortness of breath Fever Cough Anytime you experience breathing difficulty or pain when breathing, consult your doctor. Causes Diagnosis Clinical Trials For more than 100 years, National Jewish Health has been committed to finding new treatments and cures for diseases. Search our clinical trials.