32 HEMOPTYSIS General Discussion Hemoptysis, the coughing up of blood from the respiratory tract, must be differentiated from hematemesis (the vomiting of blood) and pseudohemoptysis (blood in the sputum that originates in the nasopharynx or oropharynx). Blood in the lungs may originate from bronchial arteries, pulmonary arteries, bronchial capillaries, and alveolar capillaries. Tuberculosis is the most common cause of hemoptysis worldwide. However, bronchitis, bronchiectasis, and bronchogenic carcinoma represent the most common causes of hemoptysis in the United States, with acute and chronic bronchitis accounting for up to 50% of cases. The underlying cause is never found in 15% to 30% of cases of hemoptysis. The appearance of the blood and the clinical history can offer clues to the cause of hemoptysis. Red, frothy blood mixed with purulent sputum usually is associated with an underlying pulmonary infection. Weight loss raises concern for cancer, especially in a smoker over the age of 40 years who has had hemoptysis lasting longer than 1 week. Night sweats, fever, and generalized illness may suggest tuberculosis as the cause. Persons with recent travel to Asia, South American, or the Middle East may present with hemoptysis as a result of parasitic infections such as schistosomiasis. A monthly pattern of bleeding in a menstruating woman suggests pulmonary endometriosis. Goodpasture’s syndrome should be considered if the urinalysis reveals hematuria. Medications Associated with Hemoptysis Anticoagulants Penicillamine Causes of Hemoptysis Anticoagulation therapy Bioterrorism • Pneumonic plague • T2 mycotoxin • Tularemia Bronchiectasis Coagulopathy • Hemophilia • von Willebrand’s disease • Thrombocytopenia Cocaine use Cystic fibrosis Goodpasture’s syndrome Heart failure Infection • Ascariasis • Bronchitis • Fungal infections (aspergilloma) • Hydatid cyst • Lung abscess • Mycobacteria, especially tuberculosis • Necrotizing pneumonia • Paragonimiasis Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on HEMOPTYSIS Full access? Get Clinical Tree
32 HEMOPTYSIS General Discussion Hemoptysis, the coughing up of blood from the respiratory tract, must be differentiated from hematemesis (the vomiting of blood) and pseudohemoptysis (blood in the sputum that originates in the nasopharynx or oropharynx). Blood in the lungs may originate from bronchial arteries, pulmonary arteries, bronchial capillaries, and alveolar capillaries. Tuberculosis is the most common cause of hemoptysis worldwide. However, bronchitis, bronchiectasis, and bronchogenic carcinoma represent the most common causes of hemoptysis in the United States, with acute and chronic bronchitis accounting for up to 50% of cases. The underlying cause is never found in 15% to 30% of cases of hemoptysis. The appearance of the blood and the clinical history can offer clues to the cause of hemoptysis. Red, frothy blood mixed with purulent sputum usually is associated with an underlying pulmonary infection. Weight loss raises concern for cancer, especially in a smoker over the age of 40 years who has had hemoptysis lasting longer than 1 week. Night sweats, fever, and generalized illness may suggest tuberculosis as the cause. Persons with recent travel to Asia, South American, or the Middle East may present with hemoptysis as a result of parasitic infections such as schistosomiasis. A monthly pattern of bleeding in a menstruating woman suggests pulmonary endometriosis. Goodpasture’s syndrome should be considered if the urinalysis reveals hematuria. Medications Associated with Hemoptysis Anticoagulants Penicillamine Causes of Hemoptysis Anticoagulation therapy Bioterrorism • Pneumonic plague • T2 mycotoxin • Tularemia Bronchiectasis Coagulopathy • Hemophilia • von Willebrand’s disease • Thrombocytopenia Cocaine use Cystic fibrosis Goodpasture’s syndrome Heart failure Infection • Ascariasis • Bronchitis • Fungal infections (aspergilloma) • Hydatid cyst • Lung abscess • Mycobacteria, especially tuberculosis • Necrotizing pneumonia • Paragonimiasis Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: ARTHRITIS AND ARTHRALGIA HAIR LOSS INFERTILITY, MALE SYNCOPE Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Medicine Aug 17, 2016 | Posted by admin in PEDIATRICS | Comments Off on HEMOPTYSIS Full access? Get Clinical Tree
