|
|
char = A;code = 65
char = e;code = 101
char = t;code = 116
char = i;code = 105
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result sql = Aetiology, diagnosis and management of infective causes of severe haemoptysis in intensive care units.
Aetiology, diagnosis and management of infective causes of severe haemoptysis in intensive care units.char = <;code = 60
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char = R;code = 82
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char = S;code = 83
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char = O;code = 79
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char = T;code = 84
char = H;code = 72
char = E;code = 69
char = ;code = 32
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char = V;code = 86
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char = W;code = 87
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char = n;code = 110
char = g;code = 103
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char = d;code = 100
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char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = P;code = 80
char = h;code = 104
char = y;code = 121
char = s;code = 115
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char = c;code = 99
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char = a;code = 97
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char = s;code = 115
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char = <;code = 60
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char = <;code = 60
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char = C;code = 67
char = E;code = 69
char = N;code = 78
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char = ;code = 32
char = F;code = 70
char = I;code = 73
char = N;code = 78
char = D;code = 68
char = I;code = 73
char = N;code = 78
char = G;code = 71
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = r;code = 114
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char = c;code = 99
char = e;code = 101
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char = ;code = 32
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char = a;code = 97
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char = P;code = 80
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char = k;code = 107
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char = c;code = 99
char = i;code = 105
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char = a;code = 97
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char = s;code = 115
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result sql = PURPOSE OF THE REVIEW : Infective causes of severe haemoptysis have progressively shifted to causes related to chronic inflammatory lung diseases. Physicians should, however, recognize the most common of them, for example necrotizing parenchymal infections, tuberculosis and mycetoma.
RECENT FINDINGS : The recent increase in the incidence of a devastating Panton-Valentine leukocidin-associated staphylococcal pneumonia has reminded us of the crucial role of prompt diagnosis and management. General supportive care should be administered to prevent asphyxiation in addition to starting appropriate antibiotics as soon as possible. Once the bleeding has been controlled, the diagnostic strategy should integrate a detailed medical history, physical examination, Gram stain of the respiratory specimens and chest radiograph. Computed tomography scan has dramatically improved the diagnosis and the treatment of infective causes of severe haemoptysis by assessing the cause and mechanism(s) of haemoptysis. Although bronchial arteries are the major source of bleeding, nonbronchial systemic and pulmonary arteries' involvement should be feared, especially in haemoptysis related to tuberculosis and mycetoma.
SUMMARY : Endovascular therapy should be first attempted to control the bleeding and then elective surgery performed in case of localized lesion and adequate pulmonary function. Fibreoptic bronchoscopy with broncho-alveolar lavage remains the cornerstone of diagnosis in immunocompromised hosts with haemoptysis and in the rare cases of alveolar haemorrhage related to infectious diseases.
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char = i;code = 105
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char = u;code = 117
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char = i;code = 105
char = t;code = 116
char = s;code = 115
char = .;code = 46
result sql = Aetiology, diagnosis and management of infective causes of severe haemoptysis in intensive care units.
char = b;code = 98
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char = P;code = 80
char = U;code = 85
char = R;code = 82
char = P;code = 80
char = O;code = 79
char = S;code = 83
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char = ;code = 32
char = O;code = 79
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char = ;code = 32
char = T;code = 84
char = H;code = 72
char = E;code = 69
char = ;code = 32
char = R;code = 82
char = E;code = 69
char = V;code = 86
char = I;code = 73
char = E;code = 69
char = W;code = 87
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char = :;code = 58
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char = <;code = 60
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char = >;code = 62
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char = e;code = 101
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char = s;code = 115
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char = f;code = 102
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char = s;code = 115
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char = e;code = 101
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char = s;code = 115
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char = a;code = 97
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char = r;code = 114
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char = g;code = 103
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char = s;code = 115
char = e;code = 101
char = s;code = 115
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char = l;code = 108
char = a;code = 97
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char = e;code = 101
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char = t;code = 116
char = o;code = 111
char = ;code = 32
char = c;code = 99
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char = c;code = 99
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char = l;code = 108
char = a;code = 97
char = m;code = 109
char = m;code = 109
char = a;code = 97
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = l;code = 108
char = u;code = 117
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = P;code = 80
char = h;code = 104
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = l;code = 108
char = d;code = 100
char = ,;code = 44
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = ,;code = 44
char = ;code = 32
char = r;code = 114
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char = c;code = 99
char = o;code = 111
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char = n;code = 110
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char = z;code = 122
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
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char = e;code = 101
char = m;code = 109
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char = f;code = 102
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char = x;code = 120
char = a;code = 97
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char = l;code = 108
char = e;code = 101
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char = n;code = 110
char = e;code = 101
char = c;code = 99
char = r;code = 114
char = o;code = 111
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char = i;code = 105
char = z;code = 122
char = i;code = 105
char = n;code = 110
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char = ;code = 32
char = p;code = 112
char = a;code = 97
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char = e;code = 101
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char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = t;code = 116
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char = b;code = 98
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char = c;code = 99
char = u;code = 117
char = l;code = 108
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = e;code = 101
char = t;code = 116
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = C;code = 67
char = E;code = 69
char = N;code = 78
char = T;code = 84
char = ;code = 32
char = F;code = 70
char = I;code = 73
char = N;code = 78
char = D;code = 68
char = I;code = 73
char = N;code = 78
char = G;code = 71
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = i;code = 105
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char = c;code = 99
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = v;code = 118
char = a;code = 97
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = P;code = 80
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = o;code = 111
char = n;code = 110
char = -;code = 45
char = V;code = 86
char = a;code = 97
char = l;code = 108
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = u;code = 117
char = k;code = 107
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = -;code = 45
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = p;code = 112
char = h;code = 104
char = y;code = 121
char = l;code = 108
char = o;code = 111
char = c;code = 99
char = o;code = 111
char = c;code = 99
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = n;code = 110
char = e;code = 101
char = u;code = 117
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = i;code = 105
char = a;code = 97
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = m;code = 109
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char = n;code = 110
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = r;code = 114
char = u;code = 117
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = l;code = 108
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char = r;code = 114
char = o;code = 111
char = l;code = 108
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char = f;code = 102
char = ;code = 32
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char = r;code = 114
char = o;code = 111
char = m;code = 109
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char = d;code = 100
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char = a;code = 97
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char = o;code = 111
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char = s;code = 115
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char = d;code = 100
char = ;code = 32
char = m;code = 109
char = a;code = 97
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char = a;code = 97
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char = e;code = 101
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char = .;code = 46
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char = G;code = 71
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char = e;code = 101
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char = a;code = 97
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char = s;code = 115
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char = p;code = 112
char = p;code = 112
char = o;code = 111
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char = i;code = 105
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char = d;code = 100
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char = e;code = 101
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char = o;code = 111
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char = i;code = 105
char = n;code = 110
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char = a;code = 97
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char = d;code = 100
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char = O;code = 79
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char = i;code = 105
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char = a;code = 97
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char = ;code = 32
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char = i;code = 105
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char = (;code = 40
char = s;code = 115
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char = ;code = 32
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char = p;code = 112
char = t;code = 116
char = y;code = 121
char = s;code = 115
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char = s;code = 115
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char = u;code = 117
char = g;code = 103
char = h;code = 104
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char = e;code = 101
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char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = a;code = 97
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char = ;code = 32
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char = h;code = 104
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = j;code = 106
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = s;code = 115
char = o;code = 111
char = u;code = 117
char = r;code = 114
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = o;code = 111
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char = ;code = 32
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char = l;code = 108
char = e;code = 101
char = e;code = 101
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char = o;code = 111
char = n;code = 110
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = h;code = 104
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = s;code = 115
char = y;code = 121
char = s;code = 115
char = t;code = 116
char = e;code = 101
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char = i;code = 105
char = c;code = 99
char = ;code = 32
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char = n;code = 110
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = r;code = 114
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = ';code = 39
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = v;code = 118
char = o;code = 111
char = l;code = 108
char = v;code = 118
char = e;code = 101
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = l;code = 108
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = e;code = 101
char = a;code = 97
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ,;code = 44
char = ;code = 32
char = e;code = 101
char = s;code = 115
char = p;code = 112
char = e;code = 101
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = p;code = 112
char = t;code = 116
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = t;code = 116
char = u;code = 117
char = b;code = 98
char = e;code = 101
char = r;code = 114
char = c;code = 99
char = u;code = 117
char = l;code = 108
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = e;code = 101
char = t;code = 116
char = o;code = 111
char = m;code = 109
char = a;code = 97
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = S;code = 83
char = U;code = 85
char = M;code = 77
char = M;code = 77
char = A;code = 65
char = R;code = 82
char = Y;code = 89
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = E;code = 69
char = n;code = 110
char = d;code = 100
char = o;code = 111
char = v;code = 118
char = a;code = 97
char = s;code = 115
char = c;code = 99
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = u;code = 117
char = l;code = 108
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = i;code = 105
char = r;code = 114
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = t;code = 116
char = e;code = 101
char = m;code = 109
char = p;code = 112
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = e;code = 101
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = l;code = 108
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = g;code = 103
char = e;code = 101
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = p;code = 112
char = e;code = 101
char = r;code = 114
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = m;code = 109
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = z;code = 122
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = e;code = 101
char = q;code = 113
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = f;code = 102
char = u;code = 117
char = n;code = 110
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = F;code = 70
char = i;code = 105
char = b;code = 98
char = r;code = 114
char = e;code = 101
char = o;code = 111
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = h;code = 104
char = o;code = 111
char = s;code = 115
char = c;code = 99
char = o;code = 111
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = h;code = 104
char = o;code = 111
char = -;code = 45
char = a;code = 97
char = l;code = 108
char = v;code = 118
char = e;code = 101
char = o;code = 111
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = l;code = 108
char = a;code = 97
char = v;code = 118
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = m;code = 109
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = r;code = 114
char = n;code = 110
char = e;code = 101
char = r;code = 114
char = s;code = 115
char = t;code = 116
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = g;code = 103
char = n;code = 110
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = m;code = 109
char = u;code = 117
char = n;code = 110
char = o;code = 111
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = i;code = 105
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = h;code = 104
char = o;code = 111
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = p;code = 112
char = t;code = 116
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = a;code = 97
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = v;code = 118
char = e;code = 101
char = o;code = 111
char = l;code = 108
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = h;code = 104
char = a;code = 97
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = r;code = 114
char = h;code = 104
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = s;code = 115
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = .;code = 46
result sql = PURPOSE OF THE REVIEW : Infective causes of severe haemoptysis have progressively shifted to causes related to chronic inflammatory lung diseases. Physicians should, however, recognize the most common of them, for example necrotizing parenchymal infections, tuberculosis and mycetoma.
RECENT FINDINGS : The recent increase in the incidence of a devastating Panton-Valentine leukocidin-associated staphylococcal pneumonia has reminded us of the crucial role of prompt diagnosis and management. General supportive care should be administered to prevent asphyxiation in addition to starting appropriate antibiotics as soon as possible. Once the bleeding has been controlled, the diagnostic strategy should integrate a detailed medical history, physical examination, Gram stain of the respiratory specimens and chest radiograph. Computed tomography scan has dramatically improved the diagnosis and the treatment of infective causes of severe haemoptysis by assessing the cause and mechanism(s) of haemoptysis. Although bronchial arteries are the major source of bleeding, nonbronchial systemic and pulmonary arteries' involvement should be feared, especially in haemoptysis related to tuberculosis and mycetoma.
SUMMARY : Endovascular therapy should be first attempted to control the bleeding and then elective surgery performed in case of localized lesion and adequate pulmonary function. Fibreoptic bronchoscopy with broncho-alveolar lavage remains the cornerstone of diagnosis in immunocompromised hosts with haemoptysis and in the rare cases of alveolar haemorrhage related to infectious diseases.
Publication: Curr Opin Pulm Med 2008 May ;14(3)::195-202. :doi: 10.1097/MCP.0b013e3282f79663.
Publication Date: 2008 May
Study Author(s): Fartoukh, Muriel;Parrot, Antoine;Khalil, Antoine;
Institution: Medical Intensive Care Unit and Pulmonology, Tenon Teaching Hospital, Paris, France. [email protected]
Shortcut link to this study:
Publication Date: 2008 May
Study Author(s): Fartoukh, Muriel;Parrot, Antoine;Khalil, Antoine;
Institution: Medical Intensive Care Unit and Pulmonology, Tenon Teaching Hospital, Paris, France. [email protected]
Shortcut link to this study:
PURPOSE OF THE REVIEW : Infective causes of severe haemoptysis have progressively shifted to causes related to chronic inflammatory lung diseases. Physicians should, however, recognize the most common of them, for example necrotizing parenchymal infections, tuberculosis and mycetoma.
RECENT FINDINGS : The recent increase in the incidence of a devastating Panton-Valentine leukocidin-associated staphylococcal pneumonia has reminded us of the crucial role of prompt diagnosis and management. General supportive care should be administered to prevent asphyxiation in addition to starting appropriate antibiotics as soon as possible. Once the bleeding has been controlled, the diagnostic strategy should integrate a detailed medical history, physical examination, Gram stain of the respiratory specimens and chest radiograph. Computed tomography scan has dramatically improved the diagnosis and the treatment of infective causes of severe haemoptysis by assessing the cause and mechanism(s) of haemoptysis. Although bronchial arteries are the major source of bleeding, nonbronchial systemic and pulmonary arteries' involvement should be feared, especially in haemoptysis related to tuberculosis and mycetoma.
SUMMARY : Endovascular therapy should be first attempted to control the bleeding and then elective surgery performed in case of localized lesion and adequate pulmonary function. Fibreoptic bronchoscopy with broncho-alveolar lavage remains the cornerstone of diagnosis in immunocompromised hosts with haemoptysis and in the rare cases of alveolar haemorrhage related to infectious diseases.
RECENT FINDINGS : The recent increase in the incidence of a devastating Panton-Valentine leukocidin-associated staphylococcal pneumonia has reminded us of the crucial role of prompt diagnosis and management. General supportive care should be administered to prevent asphyxiation in addition to starting appropriate antibiotics as soon as possible. Once the bleeding has been controlled, the diagnostic strategy should integrate a detailed medical history, physical examination, Gram stain of the respiratory specimens and chest radiograph. Computed tomography scan has dramatically improved the diagnosis and the treatment of infective causes of severe haemoptysis by assessing the cause and mechanism(s) of haemoptysis. Although bronchial arteries are the major source of bleeding, nonbronchial systemic and pulmonary arteries' involvement should be feared, especially in haemoptysis related to tuberculosis and mycetoma.
SUMMARY : Endovascular therapy should be first attempted to control the bleeding and then elective surgery performed in case of localized lesion and adequate pulmonary function. Fibreoptic bronchoscopy with broncho-alveolar lavage remains the cornerstone of diagnosis in immunocompromised hosts with haemoptysis and in the rare cases of alveolar haemorrhage related to infectious diseases.
PMID: 18427242
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