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What does blood in sputum signify Dr Hirennappa B Udnur

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Blood in the sputum means, it can be the first sign, it can be simple, trivial thing. Sometimes you get a bronchitis or viral infection also, we get blood in the sputum. It can be as trivial as it. So in our country, when we have blood in the sputum and it might be a mild amount of streaky hemoptysis, or it is called as hemoptysis, coughing of blood. So this can be because of any coagulation abnormality if you are taking any drugs like ecospirin or any other drugs. If you are stopping the drug, it is enough. Sometimes, it can be a really serious matter. So in our country in a young patients, it can be tuberculosis, and any pneumonias, we can get a rusty sputum and sometimes in a smokers, in elderlies, rust can be a first feature of lung cancer and there are other many causes for , real causes for blood in the sputum. Usually we just go, look out for associated symptoms in blood in the sputum, if they have fever, chest pain and cough of short duration, it might be pneumonia. So if it is subacute history, means its long duration, and they have associated cough, evening rise of temperature, night sweats, and they are exposed to a TB patients, they are staying in an overcrowded place, it can be a first manifestation of TB, which requires further evaluation. So in terms of cancer, we need to do further testing. X-ray is the first test we do and blood test and blood grouping. Sometimes it can be massive hemoptysis, more than 500 ml coughing out heavily and the BP can go down, they can end up in an emergency. They almost require like intubation on ventilation also and correction with blood. There are also some emergency procedures, if there are somebody is bleeding, they might require a surgical removal of a part of the lung. It can be fungal infection, because of the immunosuppressed host and can be because of bronchiectasis is also one of the cause. We do something called as bronchial artery embolization. Even that might be a reason for blocking the airways where blood supply to particular region is affected. That can be reduce the blood in the sputum. So we have to know the cause for the blood in the sputum. Sometimes w arrest, we localize the area of the bleeding, if it is in the right lung, left ling, we intubate and secure the separate lung and then go for a surgery because this is really an emergency. So this is a commonest ominous sign. It might be a premonitory symptom for anything big happening. So that’s the hemoptysis that we should never neglect. So sometimes it requires some massive amount of blood transfusions and admission. So any blood in the sputum should not be neglected.
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