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Coughing Up Blood
Leo Leonidas MD, FAAP
Why Have a List of Differential Diagnosis?
It is important for clinicians to frequently refer
to a list of differential diagnosis so they could
ask good questions from the patient or parent. A
good clinical history depends on a complete list of
differential diagnosis of the chief complaint or
main problem.
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CAUSES OF COUGHING UP BLOOD
Coughing up blood (Hemoptysis) is a frightening episode for a parent or child. Most of the time the blood is coming from the throat. Hemoptysis is not a common reason for visiting an emergency room or a physician. True coughing up of blood is a result of the following conditions: lung infections, bronchiectasis, cystic fibrosis, or aspirated foreign body.
INFECTIONS
Pneumonia
Pulmonary Tuberculosis
Cystic Fibrosis
Bronchiectasis
Lund Abscess
Pertussis (Whooping cough)
Inlfuenza
Aspergillosis
Coccidiodomycosis
Blastomycosis
Hemorrhagic Fevers
Paragonimiasis
INJURY
Lung Contussion
Foreign Body
Smoking Clove of Cigarettes
CARDIOVASCULAR CAUSES
Pulmonary Embolus
Multiple Pulmonary Telangiectasis
Ruptured Arteriovenous Fistula
Mitral Stenosis
Endomyocardial Fibrosis
Necrotic Pulmonary Arterial Lesions
TUMORS
Bronchogenic Cyst
Enterogenic Cysts
Mediastinal Teratoma
Bronchial Submucosal Gland Tumor
Plasma Cell Granuloma of Lung
Bronchogenic Carcinoma (Rare is childhood)
OTHERS
Hemorrhagic Disorders
Sickle-Cell Anemia
Primary Pulmonary Hemosiderosis
Pulmonary Hemorrhage
Wegener Granulomatosis
Systemic Lupus Erythematosus (SLE)
Sarcoidosis
Swyer-James Syndrome
BLEEDING WITHOUT LUNG INVOLVEMENT
Nose bleeding (Epistaxis)
Injury to the mouth or throat
Acute tonsillitis
Gingivitis
REFERENCE:
Signs & Symptoms In Pediatrics
2nd Edition, page 294
Tunnessen, Jr
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CAUSE OF MASSIVE COUGHING OF BLOOD WITHOUT PREVIOUSLY KNOWN LUNG DISEASE
Airway Hemangioma
Pulmonary Sequestration
Foregut Duplication
Congenital Arteriovenous Malformation
Hereditary Hemorrhagic Gelangiectasia
Bronchial Adenoma
Bleeding Disorder
Catamenial Hemoptysis
Bronchial Artery Aneurysm
Unilateral Pulmonary Artery Agenesis
Ehler-Danlos Syndrome
Long-Term Trahceostomy
Idiopathic Hemoptysis
Reference: THE JOURNAL OF RESPIRATORY DISEASES FOR PEDIATRICIANS, April 2002, page70
Belly Pain Air Leaks From Lungs Acute Crying Back Pain Bed Wetting Big Lymph Node Big Spleen Blood in Urine Chronic Diarrhea Chest Pain Cough Coughing Up Blood Constipation Droopy Eye Enlarged Glands Eye Swelling Excessive Thrist Facial Paralysis Fainting Spell Feeding Problem GI Bleeding Headache Head Tilt Hives High ESR Hoarseness Joint Pain Limp Leg Pain Muscle Weakness Noisy Breathing Nose Bleeding Nose Obstruction Pyuria Recurrent Infection Red Green Urine Ringing in the Ears Scrotal Swelling Seizures Stiff Neck Swelling of the Parotic Gland Toe Walking Toeing In Toeing Out Unequal Pupils Vomiting Wheezing
Leo Leonidas, MD, FAAP
Assistant Clinical Professor in Pediatrics
Tufts University School of Medicine, Boston
Attending Pediatrician
Eastern Maine Medical Center, Bangor
BANGOR, MAINE: "First City with EBPP (Evidence Based Pediatrics for Parents) Website"
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