A 7-Year-Old Girl with Hemoptysis for 3 Days

Abstract

A 7-year-old girl presented to our unit because of hemoptysis for 3 days. She had hemoptysis one to two times per day with approximately 2 to 3 mL of blood each time. The blood was bright red without clots. Amoxicillin and ethamsylate were administered for 3 days in the local hospital. She had previous episodes of hemoptysis at age 1.5 years and age 4 years. During the second episode of hemoptysis (at age 4 years), on physical examination, she had a normal heart rate and blood pressure but appeared acutely ill. Coarse breath sounds were noted on lung auscultation. A chest radiograph showed increased lung markings in the right lung, and the mediastinum and bronchi were shifted to the right (Figure 1). Doppler echocardiography showed normal structure of the heart and the right pulmonary vein was not clearly seen. Computed tomography angiography (CTA) in the local hospital showed smaller right pulmonary artery and undeveloped right pulmonary vein with normal airways. Bronchoscopy showed manifestations of bronchitis, and bronchoalveolar lavage demonstrated no hemosiderin cells.