Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis


Background: It is very important to enhance the therapeutic effect and prognosis of severe tuberculous hemoptysis after the determining of its etiological cause and the source of bleeding. The etiology and integrated curative effect of severe hemoptysis due to pulmonary tuberculosis among 112 inpatients were analyzed. Materials and Methods: The cause was retrospectively analysed. The integrated management effect after the follow-up of mean three years in 112 cases with severe hemoptysis being resulted from pulmonary tuberculosis from June 2008 to July 2012 was described. Active pulmonary tuberculosis ranked the first cause of lower respiratory tract bleeding (32/112, 28.5%), followed by old pulmonary tuberculosis (28/112, 25.0%), tuberculous bronchiectasis (25/112, 22.3%), purified tuberculous cavity (12/112, 10.7%), fungal infection in old pulmonary tuberculosis cavity (9/112, 7.1%), or broncholithiasis (6/112, 5.4%). Almost all suffers with severe hemoptysis were treated by an integrated management, including psychology, anticoagulants, vasoconstrictor agents. Etiological treatment including anti-tuberculosis and anti-infection was simultaneously or subsequently involved. Sixty-four inpatients with severe hemoptysis being failed to be cured by medical treatment were then received selective bronchial artery embolization. Four patients were received surgical wedge resection, lobectomy or pneumonectomy. The total cure rate added up to 98.2% after mean three years’ follow-up. The mortality was 1.8%. Conclusions: Active pulmonary tuberculosis was still responsible for the severe hemoptysis in the southeast region of China. Severe hemoptysis of pulmonary tuberculosis was also resulted from stable tuberculosis, tuberculous bronchiectasis, tuberculosis cavity, fungal infection, or broncholithiasis. Better clinical therapeutic effect could be attained by early etiological diagnosis and comprehensive treatment strategy.

Share and Cite:

Yang, S. , Mai, Z. , Zheng, X. and Qiu, Y. (2015) Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis. Journal of Tuberculosis Research, 3, 11-18. doi: 10.4236/jtr.2015.31002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Sidhu, M., Wieseler, K., Burdick, T.R. and Shaw, D.W.W. (2008) Bronchial Artery Embolization for Hemoptysis. Seminars in Interventional Radiology, 25, 310-318.
[2] Najarian, K.E. and Morris, C.S. (1998) Arterial Embolization in the Chest. Journal of Thoracic Imaging, 13, 93-104.
[3] Conlan, A.A., Hurwitz, S.S. and Krige, L. (1983) Massive Hemoptysis. Review of 123 Cases. The Journal of Thoracic and Cardiovascular Surgery, 85, 120-124.
[4] Winter, S.M. and Ingbar, D.H. (1988) Massive Hemoptysis: Pathogenesis and Management. Journal of Intensive Care Medicine, 3, 171-188.
[5] Halezeroglu, S. and Okur, E. (2014) Thoracic Surgery for Haemoptysis in the Contexts the Best Management Approach? Journal of Thoracic Disease, 6, 182-185.
[6] Jean-Baptiste, E. (2000) Clinical Assessment and Management of Massive Haemoptysis. Critical Care Medicine, 28, 1642-1647.
[7] Syabbalo, N. (1991) Hemoptysis: The Third-World Perspective. Chest, 99, 1316-1317.
[8] Lin, H.H., Dowdy, D., Dye, C., Murray, M. and Cohen, T. (2012) The Impact of New Tuberculosis Diagnostics on Transmission: Why Context Matters. Bulletin of the World Health Organization, 90, 739A-747A.
[9] Lordan, J.L., Gascoigne, A. and Corris, P.A. (2003) The Pulmonary Physician in Critical Care Illustrative Case 7: Assessment and Management of Massive Haemoptysis. Thorax, 58, 814-819.
[10] Hahn, S., Kim, Y.J., Kwon, W., Cha, S.W. and Li, W.Y. (2010) Comparison of the Effectiveness of Embolic Agents for Bronchial Artery Embolization: Gelfoam versus Polyvinyl Alcohol. Korean Journal of Radiology, 11, 542-546.
[11] Zhou, Z.H. (2009) Hemoptysis-Pathogenesis, Diagnosis and Treatment Progress. Modern Preventive Medicine, 36, 1398-1400.
[12] Rémy, J., Arnaud, A., Fardou, H., Giraud, R. and Voisin, C. (1977) Treatment of Hemoptysis by Embolization of Bronchial Arteries. Radiology, 122, 33-37.
[13] Yoon, W., Kim, J., Kim, Y., Chung, T. and Kang, H. (2002) Bronchial and Nonbronchial Systemic Artery Embolization for Life-Threatening Hemoptysis: A Comprehensive Review. Radiographics, 22, 1395-1409.
[14] Hirchberg, B., Biran, I., Glazer, M. and Kramer, M.R. (1997) Hemoptysis: Etiology, Evaluation, and Outcome in a Tertiary Referral Hospital. Chest, 112, 440-444.
[15] McGuinnes, G., Beacher, J.R., Harkin, T.J., Garay, S.M., Rom, W.N. and Naidich, D.P. (1994) Hemoptysis: Prospective High-Resolution CT/Bronchoscopic Correlation. Chest, 105, 1155-1162.
[16] WHO (2002) WHO Report 2002. Global Tuberculosis Control. Surveillance, Planning, Financing. World Health Organization, Geneva.
[17] Li, Y.Y. (1997) Etiology Analysis on Hemoptysis in 520 Elderly Patients. Nanjing Railway Medical College Journal, 16, 189-190.
[18] Parrish, S., Krimsky, W., Browning, R. and Alabrash, M. (2012) Novel Approaches to the Patient with Massive Hemoptysis. Journal of Community Hospital Internal Medicine Perspectives, 2, 14784-14787.
[19] Hwang, H.G., Lee, H.S., Choi, J.S., Seo, K.H., Kim, Y.H. and Na, J.O. (2013) Risk Factors Influencing Rebleeding after Bronchial Artery Embolization on the Management of Hemoptysis Associated with Pulmonary Tuberculosis. Tuberculosis and Respiratory Diseases, 74, 111-119.
[20] Corr, P.D. (2005) Bronchial Artery Embolization for Life-Threatening Hemoptysis Using Tris-Acryl Microspheres: Short-Term Result. CardioVascular and Interventional Radiology, 28, 439-441.
[21] Gourin, A. and Garzon, A.A. (1974) Operative Treatment of Massive Hemoptysis. The Annals of Thoracic Surgery, 18, 52-60.
[22] Erdogan, A., Yegin, A., Gürses, G., et al. (2005) Surgical Management of Tuberculosis-Related Hemoptysis. The Annals of Thoracic Surgery, 79, 299-302.
[23] William, A.B. and James, B.D.M. (1989) Recurrent Major Haemoptysis: Progression to Pneumonectomy. Thorax, 35, 905-906.

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.