Hemoptysis: Difference between revisions

Latest revision as of 13:06, 8 September 2022

Etiology

Source other than the lower respiratory tract
- Upper airway (nasopharyngeal) bleeding
- Gastrointestinal bleeding
Tracheobronchial source
- Neoplasm
  - Bronchogenic carcinoma
  - Endobronchial metastatic tumor
  - Kaposi sarcoma
  - Bronchial carcinoid
- Bronchitis (acute or chronic)
- Bronchiectasis
- Broncholithiasis
- Airway trauma
- Foreign body
Pulmonary parenchymal source
- Infection
  - Lung abscess
  - Pneumonia
  - Tuberculosis
  - Mycetoma ("fungus ball")
- Autoimmune/vasculitides
  - Goodpasture syndrome
  - Granulomatosis with polyangiitis
  - Lupus pneumonitis
- Idiopathic pulmonary hemosiderosis
- Lung contusion
Primary vascular source
- Arteriovenous malformation
- Pulmonary embolism
- Elevated pulmonary venous pressure (especially mitral stenosis)
- Pulmonary artery rupture secondary to balloon-tip pulmonary artery catheter manipulation
Miscellaneous and rare causes
- Pulmonary endometriosis
- Systemic coagulopathy or use of anticoagulants or thrombolytic agents

Differential Diagnosis

Bronchitis (20%-40%)
Lung cancer (15-30%)
Bronchiectasis (10-20%)
Cryptogenic (10-20%)
Pneumonia (5-10%)
Tuberculosis (5-15%)
Other serious causes:

Clinical Manifestations

History
- Bright red blood or clots (quantify amount)
Signs & Symptoms

Investigations

CXR
CT chest +/- CTPE
CBC, lytes, creatinine
Sputum culture
Bronchoscopy

Management

Acute

Vitamin K, if indicated
Tranexamic acid
Transfer to ICU if massive hemoptysis

@@ Line 3: / Line 3: @@
 * Source other than the lower respiratory tract
 ** Upper airway (nasopharyngeal) bleeding
-** Gastrointestinal bleeding
+** [[Gastrointestinal bleeding]]
 * Tracheobronchial source
 ** Neoplasm
-*** Bronchogenic carcinoma
+*** [[Bronchogenic carcinoma]]
 *** Endobronchial metastatic tumor
-*** Kaposi's sarcoma
+*** [[Kaposi sarcoma]]
-*** Bronchial carcinoid)
+*** [[Bronchial carcinoid]]
-** Bronchitis (acute or chronic)
+** [[Bronchitis]] (acute or chronic)
-** Bronchiectasis
+** [[Bronchiectasis]]
-** Broncholithiasis
+** [[Broncholithiasis]]
 ** Airway trauma
 ** Foreign body
 * Pulmonary parenchymal source
 ** Infection
-*** Lung abscess
+*** [[Lung abscess]]
-*** Pneumonia
+*** [[Pneumonia]]
-*** Tuberculosis
+*** [[Tuberculosis]]
-*** Mycetoma (&quot;fungus ball&quot;)
+*** [[Mycetoma]] (&quot;fungus ball&quot;)
-** Autoimmune/vasculitides
+** Autoimmune/[[Vasculitis|vasculitides]]
-*** Goodpasture's syndrome
+*** [[Goodpasture syndrome]]
-*** Granulomatosis with polyangiitis
+*** [[Granulomatosis with polyangiitis]]
-*** Lupus pneumonitis
+*** [[Lupus]] pneumonitis
-** Idiopathic pulmonary hemosiderosis
+** [[Idiopathic pulmonary hemosiderosis]]
 ** Lung contusion
 * Primary vascular source
-** Arteriovenous malformation
+** [[Arteriovenous malformation]]
-** Pulmonary embolism
+** [[Pulmonary embolism]]
-** Elevated pulmonary venous pressure (especially mitral stenosis)
+** Elevated pulmonary venous pressure (especially [[mitral stenosis]])
 ** Pulmonary artery rupture secondary to balloon-tip pulmonary artery catheter manipulation
 * Miscellaneous and rare causes
-** Pulmonary endometriosis
+** Pulmonary [[endometriosis]]
-** Systemic coagulopathy or use of anticoagulants or thrombolytic agents
+** Systemic [[coagulopathy]] or use of [[anticoagulants]] or thrombolytic agents
 == Differential Diagnosis ==
-* Bronchitis (20%-40%)
+* [[Bronchitis]] (20%-40%)
-* Lung cancer (15-30%)
+* [[Lung cancer]] (15-30%)
-* Bronchiectasis (10-20%)
+* [[Bronchiectasis]] (10-20%)
 * Cryptogenic (10-20%)
-* Pneumonia (5-10%)
+* [[Pneumonia]] (5-10%)
-* Tuberculosis (5-15%)
+* [[Tuberculosis]] (5-15%)
 * Other serious causes:
-** Lung abscess
+** [[Lung abscess]]
-** Fungal infection
+** [[Invasive fungal infection]]
-** ANCA-associated vasculitis
+** [[ANCA-associated vasculitis]]
-== Clinical Presentation ==
+== Clinical Manifestations ==
 * History