Hemoptysis with fever

Hemoptysis (hemoptysis) refers to bleeding from the respiratory organs below the larynx. Coughing is used to expel hemoptysis from the mouth. First, it must be distinguished from oral, pharyngeal, and nasal bleeding. Oral and pharyngeal bleeding is easy to observe local bleeding. Nasal bleeding mostly flows from the anterior nostril, and it is often easier to find a bleeding lesion just before the nasal septum. Sometimes there is a large amount of bleeding in the back of the nasal cavity, which can be misdiagnosed as hemoptysis. If the nasopharyngoscopy shows that the blood flows from the nostril along the throat wall, the diagnosis can be confirmed. A large amount of hemoptysis must be distinguished from vomiting (upper gastrointestinal bleeding). The former often has a history of tuberculosis, bronchiectasis, lung cancer, heart disease, etc. Before the bleeding, there is a cough, throat itching, chest tightness, and the blood is bright red, mixed with foamy sputum No tar-like stools; the latter often has a history of peptic ulcer, liver cirrhosis, and other medical conditions. There is upper abdominal discomfort, nausea and vomiting before bleeding. Vomiting blood is brown-black or dark red, sometimes bright red, mixed with food residue gastric juice, and tar The stool can continue for several days after the vomiting has stopped. There are different definitions of estimates of hemoptysis. Large hemoptysis usually refers to hemoptysis of more than 600-800ml or more than 300ml per hemoptysis within 24h; small hemoptysis refers to less than 100ml of hemoptysis; moderate hemoptysis refers to 100-300ml of hemoptysis. Accompanying symptoms (1) Hemoptysis with fever can be seen in tuberculosis, pneumonia, pulmonary hemorrhagic leptospirosis, epidemic hemorrhagic fever, bronchial lung cancer and so on. (B) Hemoptysis with chest pain can be seen in lobar pneumonia, pulmonary infarction, tuberculosis, and bronchial lung cancer. (3) Symptoms may be seen in pulmonary abscesses, hollow tuberculosis, and bronchiectasis. Bronchodilators also have repeated hemoptysis without sputum. This type is called dry bronchiectasis. (D) Hemoptysis with cough can be seen in bronchial lung cancer and mycoplasma pneumonia. (E) Hemoptysis accompanied with bleeding of the skin and mucous membranes should be paid attention to epidemic hemorrhagic fever and hematological diseases. (6) Hemoptysis with jaundice should pay attention to pulmonary infarction and leptospirosis.

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