Common Cause Of Hemoptysis Research Articles

Etiology, diagnostic modalities, and short-term outcomes of hemoptysis-a retrospective cross-sectional study from a tertiary care center in Qatar.

Hemoptysis is a concerning symptom characterized by the expectoration of blood from the respiratory tract, which can range from mild to life-threatening. It can be caused by various underlying conditions. Accurate diagnosis is critical for effective management. The causes of hemoptysis can vary depending on geographic location and the population's composition. In this study, we aimed to examine the etiology, diagnostic methods, and short-term outcomes of hemoptysis in Qatar, focusing on data from Hamad General Hospital (HGH), which serves as a major tertiary care center in the country. Qatar has a diverse and dynamic population, primarily composed of expatriate workers, especially from South Asia. Previous data on hemoptysis in Qatar was collected between 1997 and 2007, when the population was considerably smaller and less diverse. Given the substantial growth in population and diversity since then, this study sought to provide updated information on the causes and outcomes of hemoptysis in the region. This is a retrospective single center observational data review from the largest tertiary care center of Qatar, HGH. Patients who presented to HGH from 01/07/2015 to 30/06/2018 with hemoptysis were included in the study. Descriptive and summary statistics were described and analyzed using SPSS version 23. A total of 172 patients met the inclusion criteria. Most of the patients were male (74.4%) with a mean age of 37.9±16.4 years. South Asians (43.6%) accounted for the majority followed by Qatari nationals (20.3%). Mild hemoptysis was recorded in 89.5% of patients while only 3.5% had severe hemoptysis. The mean duration of hemoptysis was 1.72±0.72 days. The most common etiology was respiratory infection in 72.6% of the patients followed by tuberculosis (TB) and bronchiectasis 7% each. All patients were managed with observation or antimicrobials except two of the patients with severe hemoptysis who required bronchial artery embolization (BAE). There were no reports of recurrence of hemoptysis or deaths until hospital discharge. Respiratory infection is the most common cause of hemoptysis at our center. Mild hemoptysis is the major presentation and the majority improved with conservative treatment.

CAUSE OF HEMOPTYSIS IN INPATIENTS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA

AIM: Aim of the study is to nd the causes of hemoptysis in inpatients in a tertiary care hospital in south India. METHODS AND MATERIAL: Retrospective study. case sheets of Inpatients either admitted to the thoracic medicine department for hemoptysis and inpatients who later developed hemoptysis were included in the study irrespective of the amount of hemoptysis. RESULTS: pulmonary tuberculosis constitutes 78.26% with sequelae patients constituting 52.17% and active case 25%. Other causes such as bronchiectasis, COPD-chronic bronchitis, pneumonia, carcinoma lung and ILD constitute 10.86%, 5.43%, 2.17%, 2.17% and 1.08% respectively. CONCLUSION: The most common cause of hemoptysis is pulmonary tuberculosis(active and sequelae). Among the pulmonary tuberculosis patients post tuberculous sequelae is the common cause. This followed by bronchiectasis, COPD-chronic bronchitis, pneumonia, carcinoma lung and interstitial lung disease.

Pediatric Hemoptysis

Hemoptysis or expectoration of blood is one of the respiratory symptoms in children, hemoptysis is hard to detect because it is often swallowed. The common causes of hemoptysis in adults include bronchiectasis, tuberculosis, pulmonary mycosis, and lung cancer. On the other hand, hemoptysis in children is often caused by tracheobronchitis, pneumonia, bronchiectasis in cystic fibrosis, and foreign body aspiration. Bleeding of the pulmonary artery or bronchial artery is the cause of hemoptysis. Upper airway examination is important to rule out epistaxis as the cause of hemoptysis. The primary objectives of hemoptysis management are asphyxia management, bleeding cessation, and treatment of the underlying disease. When all other treatments fail to stop the bleeding, surgery is recommended.

The role of multidetector computed tomography in the diagnosis and assessment of patients with hemoptesis

Objective This study aims to assess the role of multidetector computed tomography (MDCT) in the diagnosis and assessment of patients with hemoptesis. Patients and Methods This was a prospective study carried out on a total of 20 patients who presented with hemoptysis, all referred from the Chest Department and clinic to the Radiology Department in El-Zahra Hospital for 164 slice MDCT examination; the study was carried out for a period of 1 year from January 2020 to January 2021 after receiving approval from the ethical committee of the institute. Informed consent was obtained from all patients before inclusion in the study. Results The MDCT study showed that bronchogenic carcinoma was found to be the most common cause of hemoptysis in six (30%) patients, pulmonary embolism and bronchiectasis were found in four (20%) patients, in two (10%) patients, metastasis was present due to breast and testicular cancer, and one (5%) patient, lung abscess, pulmonary hypertension, tuberculosis, and alveolar hemorrhage were present. Conclusion MDCT proved to be the imaging modality of choice in the diagnosis of hemoptysis, being superior to chest radiography in demonstrating not only causes of delay but also the extent of lung abnormalities.

Flexible Fiberoptic Bronchoscopy: Indications, Diagnostic Yield and Complications.

ObjectiveFlexible fiberoptic bronchoscopy (FFB) has become an essential procedure for diagnosing and managing various respiratory conditions. We aimed to assess the main indications, diagnostic yield, and safety of FFB in our institute.MethodsA total of 216 patients who underwent FFB between July 2009 and June 2012 at King Abdul-Aziz Medical City, Jeddah, Saudi Arabia, were reviewed retrospectively. Indications of the procedure, the diagnostic yield of variable respiratory diseases, and complications were reported.ResultOut of 216 patients, 210 (97.2%) completed FFB. One hundred and ninety-eight (91.7%) bronchoscopies were for diagnostic purposes, and the remaining 12 (5.6%) were for therapeutic aim. The mean age of patients was 50 years ± 20 years and patients. Respiratory infection, malignancy, pulmonary infiltrate in febrile neutropenia (FN), and hemoptysis in order of frequency were the main indications. The overall diagnostic yield was 46%. Mycobacterium tuberculosis (MTB) was the most common indication (26.8%) and was identified in 37.7%, whereas pneumonia was confirmed in 46.3% of the patients. Malignancy was established in 35.3% of suspected cases, while eosinophilic pneumonia was diagnosed in 100%. The diagnostic yield in pulmonary infiltrates of human immunodeficiency viral (HIV) was 85.7%. Alveolar hemorrhage was the most common cause of hemoptysis. Out of therapeutic bronchoscopy, lung collapse was the main indication. There is no mortality and complications occurred in 1.5% of the cases.ConclusionMTB was the most common indication of FFB, followed by malignancy. It has a high diagnostic yield in eosinophilic pneumonia and pulmonary infiltrates in HIV patients. FFB is shown to be a safe modality for diagnostic and therapeutic purposes.

Descending aortopulmonary vein fistula: an unusual cause of recurrent hemoptysis in a young female: a case report

Background: Hemoptysis is an alarming symptom. Its etiology may vary from mild infections to malignancies. Pulmonary infections are a common cause of hemoptysis in young adults. However, vascular malformations are also enlisted among the sources of hemoptysis. Case Presentation: A 33-year-old female presented to the institute with hemoptysis. The etiology of hemoptysis was ascertained to be an anomalous vascular connection between the descending aorta and inferior pulmonary vein draining into the left atrium. Conclusion: Descending aortopulmonary fistula (DAPVF) is a rare congenital vascular malformation representing a left-toleft shunt, and cardiac failure is a presenting feature as described in some reported cases in children. DAPVF may present as hemoptysis in adults.

Pediatric Hemoptysis without Bronchiectasis or Cardiac Disease: Etiology, Recurrence, and Mortality

To describe the etiologies of hemoptysis in patients without pre-existing bronchiectasis or cardiac disease; to assess odds of recurrent hemoptysis by diagnostic category; and to assess odds of mortality by diagnostic category. This retrospective case series included all patients with hemoptysis documented during an admission to Boston Children's Hospital from January 1, 2007 to June 1, 2017. Patients with bronchiectasis, congenital heart disease, primary pulmonary hypertension, bleeding above the glottis, hemoptysis before 38weeks of corrected gestational age, hematemesis, foreign body, and trauma were excluded. Patients were also characterized by coagulation status. Primary outcomes were recurrent hemoptysis and death. Univariate analysis was performed to determine ORs for recurrence and death per diagnostic category with infection as the reference category. In total, 257 patients met study criteria and were analyzed. The most common causes of hemoptysis were infection (n=122), neoplasm (n=58), and other diagnoses (n=49). Of the patients with infection, recurrence was 28% and all-cause mortality was 12%. Neoplasm had lower odds of recurrence (OR 0.3, P=.012) but higher odds of mortality (OR 15.8, P<.001). Thrombocytopenia had lower odds of recurrence (OR 0.2, P=.005) but higher odds of mortality (OR 5.9, P<.001). Patients with a tracheostomy had higher odds of recurrence (OR 6.3, P<.001), but lower odds of death (OR 0.4, P=.042). This study confirms that infection is the most common cause of hemoptysis in patients without severe underlying pulmonary or cardiac disease. Hemoptysis associated with neoplasm and/or thrombocytopenia confers mortality risk. Tracheostomy confers risk of recurrence. Future prospective research on diagnoses associated with hemoptysis is warranted.

A five-year analysis of patients with hemoptysis admitted to the pulmonary diseases clinic of Cumhuriyet University Hospital

This study aimed to identify the most common causes of hemoptysis and the methods utilized for the diagnosis, to determine the relationship between the etiological factors and the amount of hemoptysis, to establish the association between exposures and hemoptysis, and to reveal other possible factors related to hemoptysis in patients admitted to our clinic due to hemoptysis between January 2005 and December 2009. Thus, 385 cases were evaluated retrospectively. The most common causes of hemoptysis in the whole study population were identified as pneumonia, lung cancer and, pulmonary thromboembolism (33%, 14.8 and 14.0%, respectively). A stepwise approach including clinical and laboratory techniques, radiological methods, fiberoptic bronchoscopy, and echocardiograpy enhances the diagnosis of hemoptysis.

Causes of Hemoptysis in Renal Transplant Patients.

Hemoptysis is a symptom that can be caused by airway disease, pulmonary parenchymal disease, or pulmonary vascular disease, or it can be idiopathic. Infection is the most common cause of hemoptysis, accounting for 60% to 70% of cases. Hemoptysis is also an initial symptom of diffuse alveolar hemorrhage syndrome, although it may be absent at presentation in one-third of patients. Diffuse alveolar hemorrhage is characterized by disruption of the alveolar-capillary basement membranes because of either injury or inflammation of the arterioles, venules, or capillaries, resulting in bleeding in alveolar spaces. To date, no study in the literature has investigated the cause of hemoptysis in renal transplant patients. In this retrospective study, we aimed to investigate the causes of hemoptysis in renal recipients. The data included in this study were obtained from 352 renal transplant patients who were consulted by the pulmonology department regarding hemoptysis between 2011 and 2017 at Baskent University. Patient medical records were reviewed for demographic, clinical, radiographic, bronchoscopic features, and microbiology data. Immunosuppressive drugs and clinical outcome data were also noted. This study included 352 renal transplant patients (139 male patients with mean age of 34.9 ± 7 years and 113 female patients with mean age of 31.1 ± 5 years). Hemoptysis was detected in 17 patients (4.8%),with 3 (0.85%) having massive hemoptysis as a result of diffuse alveolar hemorrhage syndrome. Fourteen of our patient group (4%) had pneumonia, and Aspergillus species was detected in 5 patients (1.4%). The only reason for diffuse alveolar hemorrhage was immunosuppressive agents, including sirolimus and mycophenolate mofetil. Hemoptysis is an important respiratory symptom in renal transplant patients. Although community- or hospital-acquired pneumonia may result in hemoptysis, drug-induced diffuse alveolar hemorrhage and Aspergillus infection should be considered for causes in renal transplant patients.

A prospective evaluation of hemoptysis cases in a tertiary referral hospital

Cheat physicians frequently come across the symptom hemoptysis, an alerting symptom which may result from a wide variety of disorders. Objective: We aimed to determine the main causes of hemoptysis in a referral hospi. tal for chest diseases Methods: All the patients referred to our chest unit with hemoptysis during the two years of the studs period were included in the study. The medical history was taken and physical examination and chest radiograph were performed for each patient. Sputum examination for acid fast bacilli, echocardiography, ear-nose-throat examination and upper gastrointestinal system endoscopy, computer as well as tomography of thorax, were the further diagnostic investigations, the latter for selected patients. The mean age of the 72 patients (53 males, 19 females) who were included in this study was 48 + 17 years. Results: bronchiectasis was the most common cause of hemoptysis (22.&#x0D; 4 followed by lung cancer (18.9%), active tuberculosis (11.2%), and inactive tuberculosis (10.5%). Sputum smear for acid fast bacilli was performed in 51 patients and was positive in 15.6% of them. Computed tomography of thorax WART formed in 51 patients and was pathologie in 81.3%. Fiberoptic bronchoscopy was performed in 23 patients and locall the bleeding site in 67.4% of the patients. Conclusion: the most common cause of hemoptysis was bronchi. ectar lung cancer and tuberculosis in our hospital. Based on this finding, we suggest that the diagnostic approach to the patients presenting with hemoptysis should include first a detailed medical history, physical examination, and chest radiography. Secondly a sputum smear for acid fast bacilli: thirdly computed tomography of the thorax and finally fiberoptic bronchoscopy.

Coccidioides Mycetoma? A Rare Cause of Hemoptysis

SESSION TITLE: Fungal Infections 1 SESSION TYPE: Affiliate Case Report Poster PRESENTED ON: Tuesday, October 31, 2017 at 01:30 PM - 02:30 PM INTRODUCTION: Pulmonary cavities are a common cause of hemoptysis. Here we present a case of Coccidiomycosis as a casuse of hemoptysis due to mycetoma formation. CASE PRESENTATION: A 27 year-old man presented for two years of intermittent hemoptysis. His hemoptysis occurred 1-2x weekly, increasing in frequency to daily with 2-3 teaspoons in quantity three weeks prior to presentation. He denied any sick contacts, infectious symptoms, or B symptoms. He was initially born in El Salvador and lived in a rural community around livestock; he moved to the USA in 2009 where he worked in construction. He briefly lived in Tuscon, Arizona before moving to Washington DC in 2010. He has no smoking history or illicit drug use. A chest x-ray demonstrated a 2.7x3.7cm cavity in the right mid-lung field. A subsequent CT chest showed a thick-walled air-filled cavity in the superior segment of the right lower lobe with a soft-tissue mass resembling a fungal ball at the periphery. A bronchoscopy with BAL returned as Coccidiomycosis immitus/posadasii on PCR. He was initiated on fluconazole for a prolonged duration of therapy. DISCUSSION: Pulmonary cavities are frequently caused by infection, including typical bacterial organisms, anaerobes, and Mycobacterial species. Primary invasive can cause cavities but typically do so in immunocompromised individuals. In immunocompetent patients, Coccidiomycosis may cause thin- or thick-walled cavities. Due to either local invasion into pulmonary arterial branches or bronchial artery branch proliferation as a consequence of indolent cavity formation, hemoptysis may ensue. However, only a handful of cases report fungal ball formation as a consequence of Coccidiomycosis infection. Definitive therapy is with azoles, with surgical resection reserved for severe or refractory cases. CONCLUSIONS: This case demonstrates hemoptysis as a result of invasive Coccidiomycosis infection with pulmonary cavity formation and complicated by a fungal ball. Hemoptysis is a relatively common presentation in these with cavities; however, the vast minority with exposure to Coccidiomycosis will develop cavities and only a rare few will develop a fungal ball, which may have an impact on prognosis and response to antifungal therapy. This case highlights the need for close attention to Coccidiomycosis as a causative agent of hemoptysis, cavities, and mycetoma formation in immunocompetent individuals. Reference #1: Winn R, et al. Cavitary Coccidiomycosis With Fungus Ball Formation. Chest, 1994; 105(2): 412-416. DISCLOSURE: The following authors have nothing to disclose: Michael Bergman, Ryan Richard No Product/Research Disclosure Information

Bronchial artery embolization in management of hemoptysis: Safety and efficacy

Massive hemoptysis has a mortality rate of >50%. The source of massive hemoptysis is the bronchial circulation in the majority of patients. Bronchial artery embolization (BAE) is considered the most effective non-surgical tool for management of recurrent and/or massive hemoptysis. AimThe aim of this study is to assess the efficacy and safety of BAE for management of recurrent and/or massive hemoptysis. Methods and MaterialThis study included 21 patients with recurrent and/or massive hemoptysis as a prospective cohort study. All patients underwent CXR, MDCT angiography, bronchial catheter angiography, and BAE was performed for 16 patients. Statistical analysis usedData was analysed using SPSS (Statistical Package for Social Sciences) version 15. Qualitative data was presented as number and percent. ResultsFourteen patients were males, 7 females with age ranging from 27–75years for both, Post-TB complications (43%) & bronchiectasis (33%) were the most common causes of hemoptysis, followed by idiopathic hemoptysis (9.5%), lung cancer and mycetoma in (4.8%) for each. Immediate success was achieved in (100%) of patients, long term success (56%), while recurrence of hemoptysis was observed in (44%). The most common complication was femoral puncture site pain in (56%) of our patients, followed by chest pain (32%), fever & nausea (16%), arterial dissection (16%) of patients, neurological (12%) and dye reaction (4%). ConclusionsBronchial artery embolization is an effective and safe non-surgical procedure for management of massive and/or recurrent hemoptysis with no serious complications.

Clinico-radiological and pathological profile of patients of hemoptysis admitted in a tertiary care centre in Nepal

Introduction: Hemoptysis is a common and alarming symptom in patients visiting outpatient as well as emergency department. It is a non-specific complaint that can occur in different clinical conditions including cardiopulmonary and hematological diseases. The aim of our study is to know the clinico- radiological and pathological profile of patients presenting with hemoptysis. Methods: A prospective observational study was conducted in TUTH from 20th July, 2016 to 10th March, 2017. Patients presenting with hemoptysis were admitted via emergency and OPD were evaluated for the cause of hemoptysis via radiological and clinical clues. HRCT/CECT-chest and Bronchoscopy weredone for selected patients. Results obtained were evaluated. Results: A total of 115 patients were enrolled in this study. Mean age of study population was 50.49+14.07 years and mean amount of hemoptysis was 28.27+14.07 ml. Post TB fibrobronchiectasis was found to be the most common cause of hemoptysis in 29.6%. HRCT/CECT-chest was the most sensitive diagnostic test when employed alone with positive yield of 83.3%. However, it failed to locate three cases of lung cancer. When combining a CT study together with a bronchoscopy, the positive yield increased to 100%. Patients diagnosed with lung carcinoma had significant history of smoking, 88.88% patient with diagnosis of lung carcinoma had history of smoking. Conclusion: Hemoptysis is a common symptom arising from varied clinical conditions. Even small amount of hemoptysis should not be ignored and investigated properly. The combined use of bronchoscopy and CT-chest has the best yield in evaluating hemoptysis. In our clinical context, Post TB fibrobronchiectasis was the most common cause of hemoptysis.

Etiology and outcome of moderate-to-massive hemoptysis: Experience from a tertiary care center of North India.

The aim of this study was to evaluate the etiology of hemoptysis in patients presenting to emergency department of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Prospectively 110 patients presenting to the emergency department with history of hemoptysis were screened for a period of one and half years. Out of these, 64 patients having true hemoptysis were enrolled in the study. The patients were clinically evaluated with detailed history. Radiological evaluation included chest x rays and computerized tomogram. Sputum examination and bronchoscopy was done to establish the etiology. All the patients were conservatively managed using intravenous fluids, antibiotics, anti-tussive and anti-fibrinolytic drugs. Bronchial/pulmonary artery embolization was performed for controlling ongoing bleeding/re-bleeding. All the patients were followed up till discharge or death. The mean age was 41.8 ± 15.16 years with male preponderance. Pulmonary tuberculosis (active/ sequel) was the most common etiology (65%), followed by community acquired pneumonia (10.93%), bronchiectasis (9.3%), carcinoma lung (7.18%) and miscellaneous causes (8.6%). Almost all patients (98%) had severe hemoptysis (>100 ml in 24 hours). Abnormalities in bronchial circulation were present in 59.4% and 14% of patients had pulmonary circulation abnormalities. 65% patients responded to conservative treatment. 23.4% patients under went intervention out of which 73.3% underwent bronchial artery embolization (BAE) and remaining 26.6% underwent pulmonary artery embolization (PAE). One patient died during hospital stay due to necrotizing pneumonia and another left hospital against medical advice (outcome unknown). TB (active/sequel) remains the most common cause of hemoptysis in patients admitted in emergency department. Non-TB causes like primary bronchiectasis, carcinoma lung and pneumonia are other important causes. Conservative management suffices in majority patients for controlling active bleed.

Etiologies of hemoptysis in children: A systematic review of 171 patients.

To provide prevalence rates for the most common causes of hemoptysis in children. A systematic review of articles from PubMed, the OVID Cochrane Reviews (1960-2015), and EMBASE (1991-2015) was undertaken. Additional articles were identified by reviewing the bibliographies of selected studies. Search terms included hemoptysis, children, and humans. Only case studies and cohorts that examined the causes of hemoptysis in children (birth to 21 years) were included; at least 10 patients were required of each study. Inclusion criteria, patient number, age range, patient source, and categorical and specific etiologies of hemoptysis were recorded. From the 1,858 studies identified, seven were selected for inclusion. Eighty-nine percent of participants were found to have a specific etiology for hemoptysis. Of the categorical etiologies identified, infection (37.57%), "other causes" (31.79%), heart disease (6.36%), and neoplasia (4.05%) were the most common. Pneumonia, bronchitis, and pulmonary tuberculosis were the most common specific etiologies identified. By its nature, this study was subject to selection bias and under representation of specific etiologies. Most pediatric patients presenting with hemoptysis have a specific etiology; pneumonia is the most common. A thorough history, physical exam, and focused laboratory evaluation is recommended for such patients. Pediatr Pulmonol. 2017;52:255-259. © 2016 Wiley Periodicals, Inc.

Analysis of the etiology of hemoptysis and its diagnosis and treatment in 106 cases

To investigate the etiology and clinical manifestation of hemoptysis in children. A retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed. A total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis. Hemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.

Osler-Weber-Rendu disease: A rare cause of recurrent hemoptysis.

Osler-Weber-Rendu disease, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant condition causing systemic fibrovascular dysplasia. It has an incidence of 1-2/100,000. Phenotypic variation is extreme ranging from asymptomatic to severely symptomatic, from cases with no or few mucocutaneous lesions to those with diffuse cutaneous telangiectasia. We discuss a case of Osler-Weber-Rendu disease causing diffuse cutaneous telangiectasia and hemoptysis. The patient presented with complaints of hemoptysis and was extensively examined and investigated before being diagnosed with Osler-Weber-Rendu disease. We successfully managed the patient's hemoptysis by bronchial artery embolization. This case emphasizes the need for careful examination and investigation and to consider such rare diseases when all the common causes of hemoptysis are ruled out. An early and proper diagnosis will lead to more effective management of such a rare disease with few treatment options available.

Hemoptysis: A Prospective Analysis of 110 Cases

Background: Hemoptysis is one of the commonest manifestations of the various underlying disease. A major problem in managing hemoptysis is the wider spectrum of causative factors. The effective management of hemoptysis depends upon identification of the etiology and localization of the site of bleeding. Objective: The objective of present study was to validate the relative frequency of different causes of hemoptysis and to identify its various risk factors. Methods: This 2-year prospective study was carried out on 110 patients presenting with hemoptysis. Routine blood investigations and chest radiographs were done for all patients. Bronchoscopy and HRCT chest was done for selected patients. Results obtained were evaluated. Results: Male to Female ratio was found to be 2.23:1. A total of 73.63% (n=81) of patients were admitted for the first episode of hemoptysis and 26.36% (n=29) for recurrent hemoptysis. Bronchiectasis was found to be the most common cause of hemoptysis in 34.55% patients, followed by old tubercular lesions in 26.36% of patients. History of blood stained sputum was given by 59 (53.64%) patients, frank hemoptysis was reported by 33 (30%) patients, and 18 (16.36%) patients gave the history of hemoptysis. Conclusion: Even one episode of hemoptysis should not be ignored and investigated properly. Bronchiectasis was the most common cause of hemoptysis in followed by old tubercular lesions.

Evaluation and Management of Massive Endotracheal Hemorrhage in Pediatric Patients: A Case Report and Review of Literature

Massive hemoptysis is a frightening and life-threatening event in children. Prompt, aggressive evaluation and management are necessary. The most common cause of hemoptysis in a pediatric patient is infectious, but other various etiologies including tracheotomy related problems, cystic fibrosis, bronchiectasis, congenital anomalies of the cardiopulmonary vasculature and suction trauma must be considered as well. Presented is a report of a case of acute, massive endotracheal hemorrhage with multiple methods of management including balloon tamponade, highly selective embolization, and mainstem occlusion. This case is an addition to our previously reported case series of nine pediatric patients with massive pulmonary hemorrhage. Various diagnostic and management techniques of hemoptyis in pediatric patients are discussed with an extensive review of the literature.

Hydatid disease of the lung presenting with hemoptysis and simulating a lung abscess

Hydatidosis is one of the most important zoonotic diseases in the world. In this report, we describe a 25-year-old patient from Guntur district of Andhra Pradesh who presented with cough, chest pain, dyspnoea, and hemoptysis due to hydatid disease of the lung. Although it is one of the less common causes of hemoptysis, hydatid disease of the lung requires greater attention in countries such as India, where hydatid cyst disease is common.