Cause for blood in cough?

Chief Complaint A 29 y/o male was referred for a non-resolving lung cavity. He also complains of productive cough with blood-streaked sputum. History He is a smoker for past 6 years and drinks alcohol occasionaly. He has h/o pulmonary tuberculosis and is on medication for the same. A PPD measured 25 mm of induration. Examination Cardiac and abdominal examination was wnl. Investigations WBC: 10,500 per mm3, Neutrophils 65% , Lymphocytes 15% and eosinophils 14%, hematocrit 50% Platelet count was 300,000 per mm3. Urea nitrogen was 15 mg /dl, and serum creatinine was 0.8 mg/dl Treatment Your views?



As it is a case of non - resolving lung cavity and a known case of PULMONARY tuberculosis on ATT - hemoptysis could be due to erosion of vessel wall in the cavity . Also CT scan chest is indicated for further evaluation of non - resolving lung cavity- which could be Malignancy Also a bronchoscopy and if suspicious- bronchoscopic biopsy may be indicated

Hemoptysis Pt is on ATT You said nonresolving cavity Chr Smoker This suggest active c/o pulmonary tuberculosis likely MDR Send cbnaat and tb gold test Pt may need cat2 Also r/o malignancy

Thanx dr Vipin Bihari Jain

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Non resolving lung cavity.. despite ATT.. Dd. Open negative syndrome. MDR OR XDRTB. Atypical Mycobacterial lesion. Non tuberculous lesion. Sug. Clincoimaging correlation.. HRCT thorax Sputum... zn smears.. for 3 consecutive days Sputum for cbnaat.. and mycobacterial culture... If positive growth... c. s.. with first line and secondary AT drugs.. SPUTUM CYTOLOGY FOR MALIGNANT CELLS HIV TESTS DIABETES SCREENING

Sputum analysis considering MDR TB. Secondary fungal infection. Also see for HIV status.

Koch's chest Allergic reaction. Generally haemoptysis is due to erosion of blood vessels. Needs further investigation and evaluation to conclude.

Thanks Dr Dinesh Gupta

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Needs cough syrup having brochodilator and bromhexine

Thanks Dr. Dinesh Gupta, Dr. Shivraj Agrawal

Plz get the HRCT thorax and sputum test Meanwhile start this treatment along wid Adv. Tab. Rifampacin Tab isoniazid Tab Augmentin625mg TDS Syp. Xpect-A 2tsp Tds Tabz pan40 BD Tab. A-Z gold OD Tab


Eosinophilic Tubercular needs both aspects to be seen

Diseases Related to Discussion

Pulmonary Tuberculosis
Allergic Reaction