Man coughs up 300 ml of blood due to sequelae of tuberculosis

The patient coughed up a cup of fresh red blood, had difficulty breathing, and felt dizzy. Doctors at Tam Anh General Hospital successfully stopped the bleeding.

On June 15, Dr. Dang Thi Mai Khue, Department of Internal Medicine, Tam Anh General Hospital, Ho Chi Minh City, said that Mr. Le Van Minh (71 years old, Ho Chi Minh City) was rushed to the emergency room in a state of coughing up a lot of bright red blood, having difficulty breathing, feeling dizzy, and feeling tired. This was the first time he had coughed up about 300 ml of blood.
CT scan results showed that the patient had bronchial dilatation and bronchial vascular hyperplasia after pulmonary tuberculosis, leading to coughing up blood.

The doctor stopped Mr. Minh's bleeding by using a flexible tube to aspirate blood and intervene with the blood vessels under the guidance of a DSA machine. The patient coughed up all the black blood (also known as anti-blood tail) and cleared his lungs. Currently, Mr. Minh's health is stable and he has been discharged home to rest and avoid strenuous exercise. He will have regular check-ups and is recommended to get flu shots, pneumococcal shots, etc. to avoid the recurrence of coughing up blood.

Before and after images of bronchoscopy and blood aspiration for a patient. Photo: Tam Anh General Hospital

According to Dr. Mai Khue, medical intervention in a case of hemoptysis with a large amount of progress is very difficult. In these cases, if medical intervention fails, surgery must be applied. After treatment, if Mr. Minh continues to cough up blood, he will be consulted and considered for surgery to remove the dilated bronchus. At that time, the doctor will assess whether the lung function meets the conditions for surgery or not.

Bronchiectasis is a condition of irreversible dilation of part of the bronchial tree, and is also a common manifestation of sequelae after pulmonary tuberculosis. Coughing up blood is a symptom and complication of bronchiectasis because the blood vessels in the bronchial wall are dilated and ruptured.

Dr. Mai Khue examines a patient after successful medical hemostasis intervention. Photo: Tam Anh General Hospital

In cases where the patient coughs up blood due to bronchiectasis after pulmonary tuberculosis, medical hemostasis treatment will be applied. The doctor will re-evaluate whether the patient has been reinfected with tuberculosis or not to treat appropriately.

People with a history of pulmonary tuberculosis should be examined. If coughing up too much blood, it will cause flooding of the lungs, leading to a state of hemoptysis, acute respiratory failure, and respiratory arrest.

Kim Thanh

* Patient's name has been changed.

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