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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pasteurella multocida has been implicated as the cause of a variety of respiratory conditions (eg, bronchitis, pneumonia, lung abscess, empyema), but hemoptysis has been noted only in conjunction with other lung conditions. We report a case in which hemoptysis was the sole manifestation of Pasteurella infection. The patient was a middle-aged man with severe obstructive lung disease and exposure to cats. Diagnosis was made by bronchoscopy and high-dose penicillin was required for resolution.
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PMID:Hemoptysis as the sole presentation of Pasteurella multocida infection. 959 62

Undetected foreign body aspiration is a well-known problem not only in children and patients with predisposing conditions like mental retardation, seizures or brain tumours, but also in healthy subjects. The clinical signs are quite different. Haemoptysis, cough, recurrent or chronic penumonia and bronchitis may occur. These symptoms are often accompanied by fever, weight loss and night sweat. Atelectasis, respiratory distress or death have been described. We demonstrate the case of a 39-year old man with Down syndrome who was transferred to our hospital because of pneumonia in the left lower lobe that had been lasting for about two months. It had been resistant to several antibiotic regimens. Computerised tomography led to the suspicion of a bronchial carcinoma with poststenotic infiltration of the lower lobe. Fibreoptic bronchoscopy and biopsy confirmed the diagnosis of a foreign body in the distal part of the left main bronchus. After two weeks of treatment with ciprofloxacin regression of the acute inflammation occurred. During a second bronchoscopy we could extract the foreign body (a 1 x 1.7 cm vertebra of a dove). It is concluded that undetected foreign body aspiration can occur in various clinical settings and fibreoptic bronchoscopy is a suitable approach providing an exact diagnosis.
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PMID:[Aspiration pneumonia caused by vertebrae of a dove in a 39 year old patient with Down syndrome]. 1044 52

The exact role of fibre-optic bronchoscopy (FOB) and CT of the chest in the diagnosis of patients presenting with haemoptysis and a normal or non-localizing chest radiograph has not been clearly defined. A study was designed to evaluate 50 patients presenting with haemoptysis and a normal or non-localizing chest radiograph using FOB and high-resolution computed tomography (HRCT). A definitive diagnosis was established in 17 (34%) patients. The aetiologies included bronchiectasis (24%), bronchial adenoma (6%), tuberculosis (2%) and bronchitis (2%). The diagnosis was made by HRCT in 15 (30%) patients, while FOB was diagnostic in five (10%) patients. The diagnosis was made by HRCT and FOB in all patients with focal airway abnormalities. Therefore, HRCT effectively delineated abnormalities of both the central and peripheral airways. It is concluded that CT should be obtained prior to FOB in all patients presenting with haemoptysis and a normal or non-localizing chest radiograph.
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PMID:Haemoptysis in patients with a normal chest radiograph: bronchoscopy-CT correlation. 1134 64

The incidence of bronchiectasis (BCT) has probably decreased in developed countries in recent years, but reliable statistical data on its occurrence are still lacking. The aim of the present study was to retrospectively evaluate the prevalence, age distribution and aetiology of BCT, diagnosed in a selected series of symptomatic patients of a Western country by using bronchography. The authors analysed the main known predisposing and associated conditions (PACs), and the occurrence and age distribution of BCT in 144 consecutive patients who underwent bronchological examination (fibreoptic bronchoscopy and bronchography) in the years 1987-1994 because of recurrent purulent bronchitis and/or haemoptysis. The overall prevalence of BCT was 34% (49/144); its age distribution was: 17.2% (0-10 yrs), 43.7% (11-20 yrs), 38% (21-30 yrs), 37.5% (31-40 yrs), 33.3% (41-50 yrs), 40% (51-60 yrs), and 20% (61-70 yrs). Thirty-one PACs were found in 29/144 patients of the whole study group. The prevalence of BCT was significantly higher in the subgroup of 29 patients with PACs than in the subgroup of 115 patients without PACs (75.9% versus 23.5%; p < 0000001). The aetiology of BCT was mainly unexplained, as it was only possible to detect 24 PACs in 22/49 patients with BCT (44.9%): congenital, genetic and immune disorders (eight), localized airways obstructive diseases (five), pulmonary infections (three), bronchial asthma (two), pulmonary lobar fibrosis (two), ulcerative colitis (two), dermatomiositis (one), and toxin inhalation (one). The authors conclude that bronchiectasis still occurs in a large percentage of symptomatic patients of a developed country in the post-antimicrobial era, especially in the second to sixth decades, as well as in the presence of predisposing and associated conditions; its aetiology remains unknown in more than half of cases.
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PMID:Prevalence, age distribution and aetiology of bronchiectasis: a retrospective study on 144 symptomatic patients. 1094 67

Haemoptysis is an alarming symptom, and the management depends upon the aetiology. Emergency management depends upon localization of the site of bleeding by roentgenogram, computerized chest tompgraphy and bronchoscopy. We prospectively evaluated 52 patients with haemoptysis admitted to the Chest Hospital, Kuwait for 1 year (January 1998 to December 1998) and followed them up for 1 year (January 1999 to December 1999). There were 42 males (80.8%) and 10 (19.2%) females, with a mean age of 42.2 (16-86) years. Of these, 26.9% were Kuwaiti nationals, 36.5% were Arab non-Kuwaiti nationals, 34.6% were Asians and 1.9% were other nationals. The aetiologies of haemoptysis were bronchiectasis (21.2%), old pulmonary tuberculosis with bronchiectasis (17.3%), active pulmonary tuberculosis (15.4%), bronchitis (5.8%), aspergilloma, rheumatic heart disease and carcinoid (1.9%). Aetiology could not be identified in 25% of patients. The site of bleeding in haemoptysis could not be localized by the consultants in 18 (32%) by roentgenogram. 16 patients (37%) by CT scan and 23 patients (50%) by Fibreoptic bronchoscopy. Sequential estimation of hemoglobin showed a mean of 13.56 (SD 1.9) and 13.31 (SD 1.8) after 24 h. The difference in mean was statistically significant (p<0.036). Conservative management was given in 80.8%, and embolotherapy or surgical intervention in 19.2% of patients. Only 12% of patients had recurrent haemoptysis at 1-year follow up. In conclusion, bronchiectasis and pulmonary tuberculosis were the major causes of haemoptysis in this study. Roentgenogram, CT scan and fibreoptic bronchoscopy are useful for localizing the site of bleeding. Sequential estimation of haemoglobin may be helpful in assessing the severity of haemoptysis, but larger studies are required to address this observation. The outcome of haemoptysis is generally good, with a low mortality and recurrence rate.
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PMID:Haemoptysis: aetiology, evaluation and outcome--a prospective study in a third-world country. 1145 10

Antineutrophil cytoplasmic antibodies (ANCA) are useful serologic markers for the diagnosis and management of patients with Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). However, problems in diagnosis and classification may occur when patients with other disorders develop ANCA. A 7-year review (1993-1999) disclosed 247 patients whose sera tested positively for ANCA by an indirect immunofluorescence method: 166 patients for cytoplasmic-ANCA (C-ANCA) and 81 patients for perinuclear-ANCA (P-ANCA) Twenty-seven patients had active pulmonary disease and underwent open-lung biopsy or transbronchial biopsy. Eight patients (30%) had a disease other than WG or MPA, and their clinical, pathological, and serological findings were reviewed. The patients, all women, ranged in age from 28 to 77 years (median, 37 y). Dyspnea (n = 6), cough (n = 6), chest pain (n = 2), and/or hemoptysis (n = 2) were present. The duration of symptoms lasted from 3 weeks to 6 years (median, 6 mo). ANCA titers were C-ANCA (n = 4; range, 1:40-1280) or P-ANCA (n = 4; range, 1:40-640). The lung biopsies disclosed nonspecific interstitial pneumonia (n = 4), bronchiolitis obliterans organizing pneumonia (n = 1), diffuse alveolar damage (n = 1), organizing diffuse alveolar hemorrhage without capillaritis (n = 1), and necrotic granuloma (n = 1). No cases showed characteristic histology for WG or MPA. The final diagnoses were various connective tissue disorders (n = 5), chronic hypersensitivity pneumonia (n = 1), postinfectious bronchitis/bronchiectasis (n = 1), and ulcerative colitis-related lung disease (n = 1). Surgical pathologists should be aware that significantly elevated ANCA titers may be associated with diverse forms of pulmonary disease. ANCA positivity alone, in the absence of appropriate clinical or pathologic findings, should not be used to substantiate a diagnosis of WG or MPA.
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PMID:Antineutrophil cytoplasmic autoantibody in the absence of Wegener's granulomatosis or microscopic polyangiitis: implications for the surgical pathologist. 1242 4

Among 3498 patients with hemoptysis 513 had normal chest x-ray picture. Bronchoscopy performed in all these patients allowed to recognise malignant neoplasms of the lungs, trachea and pharynx in 109 patients. In 222 patients--nonspecific bronchitis and in 46--tuberculosis were recognised. In 86 patients diagnosis was not established.
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PMID:[Frequency and causes of hemoptysis and role of bronchoscopy in patients with normal chest roentgenogram hospitalized in the Department of Physiopneumonology Silesian Medical University in the years 1961-1996]. 1213 43

As fibre-optic bronchoscopy and CT thorax become more widely used, patients with haemoptysis who had normal CXR and sputum results are more commonly offered both CT and bronchoscopy to exclude lung cancer. Doctors who are under possible litigation pressure arising from missed diagnoses of lung cancer are often exhaustive in their investigations, even when the haemoptysis has been transient. The present study aims to investigate the number of cancer patients who can be detected with the two investigations, and compare recent similar study results with archive results. We found that despite the use of more efficient investigation tools, the yield is paradoxically much lower and, hence, less cost-effective than that of previous studies. The likely reason is that doctors tend to over-investigate, even for short-term, minimal blood-streaked sputum, which is common among simple bronchitis. In order to be more cost-effective, these investigations should be used more selectively and for high risk patients such as those with prolonged haemoptysis and those who are heavy smokers.
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PMID:Cost-effectiveness of CT thorax and bronchoscopy in haemoptysis with normal CXR for exclusion of lung cancer. 1245 8

The aim of this study was to determine the influence of brachytherapy on the prognosis in advanced NSCLC, elaboration of clinical criteria useful in patients qualification to brachytherapy and the radiation method optimization. Between January 1994 and June 1998, 325 patients with symptomatic inoperable endobronchial obstructing lung cancer received brachytherapy alone or combined with external beam irradiation with palliative or radical intent. Patients were given 1 to 4 temporary Ir-192 endobronchial implants at the site of obstruction. Implant doses ranged from 6 to 12 Gy specified at a radius of 1 cm from the centre of the source. Total implant doses ranged from 6 to 24 Gy. Depending on radical or palliative intents external beam irradiation doses ranged from 20 to 60 Gy. The results were compared with results achieved in control group (N = 191) treated exclusively with external beam irradiation. Patients who received combined treatment revealed higher frequency of release or disappearance of hemoptysis, dysponea and atelectasis. Also the duration of clinical remission was significantly longer with combined treatment. In the group treated with radical intent higher percentage of patients with total tumor regression in both endoscopic and radiologic view was observed after tele--and brachytherapy compared with teleradiotherapy alone (respectively 29.8% and 19.4%). The group treated with palliative intent brachytherapy alone provided response rates comparable to those achieved with external beam irradiation alone or tele and brachytherapy. The relative risk of fatal pulmonary haemorrhage (FPH) and radiation induced bronchitis (RIB) were higher when NTD > 70 Gy, brachytherapy and laser therapy were administered and in patients with lobar bronchus infiltration. Knowledge of risk doses of FPA and RIB allow to optimise brachytherapy in patients with advanced NSCLC.
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PMID:[The role of high dose rate (HDR) brachytherapy in advanced non-small cell lung cancer]. 1251 25

The endobronchial brachytherapy procedure involves the insertion of an afterloading catheter into bronchus in close proximity to an endoluminal lesion, and to perform limited irradiation sparing as much as possible normal health tissues. The catheter is inserted during a classical flexible bronchoscopy. Three types of indications have been discussed: (i) palliative treatment of lung carcinoma, with or without laser desobstruction: an improvement in respiratory symptoms was observed in 60 to 80% of the cases; (ii) curative treatment for localised endobronchial carcinomas, in previously irradiated patients, or in case of contraindication of surgery or external beam irradiation; local control rate range from 60 to 70% at 2 years; (iii) combination of external irradiation and brachytherapy in the first line treatment of lung cancers. Two randomised trials did not show any improvement in survival for this approach; however, they have included advanced diseases. In the opposite, this association seems very effective for early stage lung carcinomas. Two major complications were regularly reported, haemoptysis and radiation bronchitis. Predictive factors for these toxicities are actually better known: haemoptysis could be due to a progressive disease more often than to brachytherapy itself; technical factors (dose, volume, fractionation), however, could explain a number of radiation bronchitis, and their incidence could decrease in the future.
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PMID:[Endobronchial brachytherapy: technique and indications]. 1264 15


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