Excessive bloody foamy sputum

Introduction A large amount of bloody foam refers to a foam-like sputum containing a large amount of blood, and the sputum is red. A large amount of foamy sputum can be found in pulmonary aspergillosis (which can be accompanied by alcohol); pink foamy mites are seen in pulmonary edema. Chronic lung abscess, bronchiectasis, etc. may also have foam sputum. The main pathogen of pulmonary aspergillosis is Aspergillus fumigatus, and some pathogenic bacteria include Aspergillus flavus, Corynebacterium, Aspergillus, Aspergillus niger, Aspergillus nidulans and Magnaporthe oryzae. Most are secondary infections, and the primary is rare.

Cause

The diseases that cause this symptom are:

1. Common bronchial diseases include bronchiectasis (tuberculosis or non-tuberculosis), chronic bronchitis, endobronchial tuberculosis, and bronchial carcinoma (primary lung cancer). Less common are benign bronchoma, intrabronchial stones, non-specific bronchial ulcers.

2, lung diseases are common pulmonary tuberculosis, pneumonia, lung abscess, etc., less common are pulmonary blood stasis, pulmonary infarction, malignant tumor metastasis, pulmonary cyst, pulmonary fungal disease, paragonimiasis. Tuberculosis is one of the most common causes of hemoptysis.

3, cardiovascular disease is more common is hemoptysis caused by mitral stenosis. Hemoptysis can also occur in certain congenital heart diseases such as atrial septal defect, patent ductus arteriosus, and other pulmonary hypertension.

4, other blood diseases (such as thrombocytopenic purpura, leukemia, hemophilia, etc.); acute infectious diseases (such as pulmonary hemorrhagic leptospirosis, epidemic hemorrhagic fever, etc.); connective tissue diseases (such as nodular multiple arteries) Inflammation); endometriosis and the like.

an examination

Related inspection

Pulmonary examination lung function test

Patients with aspergilloma can have symptoms of cough and hemoptysis, and systemic symptoms are not obvious.

Chest X-ray examination

Allergic type showed increased lung texture or lung infiltration; invasive type showed changes in bronchial pneumonia. The Aspergillus ball is often located in the cavity, the cavity is a half-moon shape, and the sphere moves like a pendulum.

2. Inspection

(1) Mycelium and spores can be seen by sputum smear microscopy;

(2) Repeated sputum culture positive is helpful for diagnosis;

(3) A large number of eosinophils and total blood IgE were observed in allergic patients;

(4) Aspergillus antigen skin test, serum precipitation test positive can help diagnosis.

Differential diagnosis

The following diseases that cause this symptom need to be identified.

1, bronchiectasis: a small number of patients with longer duration, more sputum, static can be divided into three layers: the upper layer is foamy, the middle layer is green and turbid, the bottom layer is thick pus. Hemoptysis is common and may be the first and only complaint, hemoptysis is caused by capillary erosion, sometimes caused by bronchial artery and arterial anastomosis. Repeated fever or chest pain is common, with or without obvious pneumonia. The above symptoms can be diagnosed. In advanced stage with chronic bronchitis and emphysema, there may be wheezing, shortness of breath and other respiratory insufficiency and pulmonary heart disease.

2, tuberculosis: typical pulmonary tuberculosis begins slowly, the course of the disease is longer, low fever, fatigue, loss of appetite, cough and a small amount of hemoptysis. However, most patients have mild lesions and often no obvious symptoms. They have been found by X-ray health examination. Some patients have sudden hemoptysis, but they can often be traced to mild toxicity symptoms during the course of the disease.

3, mitral stenosis:

1 sputum with blood or blood stasis, and bronchitis, lung infection, and pulmonary congestion or capillary rupture; often accompanied by paroxysmal dyspnea at night; mitral stenosis, late bleeding, pulmonary infarction, but also hemoptysis;

2 A large amount of hemoptysis is caused by a sudden increase in pressure in the left atrium, resulting in rupture of the bronchial vein. More common in the early stage of mitral stenosis, only patients with mild or moderate pulmonary artery elevation.

3 pink foam sputum, caused by capillary rupture, is a characteristic of acute pulmonary edema.

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