Hemoptysis in Pediatric Patients

Abstract

Hemoptysis is defined as the expectoration of blood or blood-tinged sputum. Blood-tinged sputum is a rare finding in the pediatric population. Finding the cause and treatment of the hemoptysis in pediatric patients is largely dependent on the history. In children, the most common causes of hemoptysis are infection and tracheostomy-related complications. Other causes include aberrant bronchial circulation, aspiration of foreign bodies, and bronchiectasis associated with cystic fibrosis. Due to the rarity of hemoptysis in pediatric patients, diagnosis and management of these patients can be difficult. It is important to refer to case reports and literature to best manage these patients. We report a case of a 3-year-old male patient who presented to the emergency department (ED) with a one-day history of hemoptysis. He presented with his adopted mother who was unable to provide a comprehensive past medical or family history other than stating that the patient has had recurrent bronchial infections since his adoption. She stated that the patient had only one episode of hemoptysis just prior to arrival. The patient did not appear to be in any respiratory distress and did not have any episodes of hemoptysis while in the ED. Due to his afebrile status and lack of evidence of current bleeding, the only intervention administered was an albuterol breathing treatment. He responded well to the breathing treatment and was discharged home with instructions to follow up with his primary care provider.

Recurrent massive hemoptysis from distal pulmonary pseudoaneurysms complicating invasive aspergillosis in a teenager

“…Empirical antifungal treatment is often used in neutropenic children with fever who are not improving despite treatment with antibiotics; this one is then adapted to infectious samples analysis [ 1 – 6 ]. Small to mild hemoptysis is sometimes encountered in patients with invasive aspergillosis, whereas massive hemoptysis with blood loss >240 mL or >8 mL/kg in 24 hours is a much rarer but frequently fatal complication (5-10% of invasive aspergillosis patients) [ [6] , [7] , [8] – 9 ]. Bleeding commonly originates from bronchial arteries (>50%), whereas other locations such as intercostal arteries (20%), internal thoracic arteries (15%), inferior phrenic arteries (7%), and pulmonary arterial branches (4%) are more rarely encountered [7] .…”