Clinical Features Of76Cases With Hemoptysis In Chongqing Children’s Hospital

Objective In order to study that how to diagnose and cure forhemoptysis in children,this study was designed to investigate the clinicalfeatures of hemoptysis in Chongqing.Methods A retrospective study of76children with hemoptysisadmitted to the Children’S Hospital Chongqing Medical University from2009to2011Results(1) We identified76cases of hemoptysis.The ratio of incidence ofhemoptysis in boys and girls was1.2:1. The youngest was1month and8days old.The oldest was16years and9months old.The mean age was7.25±4.4years old.(2) In our study,infectious disease is the most common reason.Thereare51cases in all,including30patients(39.5%) of pneumonia(1case ismycoplasma pneumonia),16patients(21.1%) of tuberculosis and5patientsof tracheobronchitis.In noninfectious diseases, idiopathic pulmonaryhemosiderosis(IPH) is the major cause.3patients(3.9%) were made adefinite diagnosis and8cases were suspected.3patients(3.9%) were diagnosed epistaxis.1patients(1.3%) was diagnosed bronchiectasia.1patients(1.3%) was diagnosed foreign body aspiration.1patients(1.3%)was diagnosed severe hand-foot and mouth disease.In addition,the causesof14patients are not clear,of which4cases were suspected tuberculosis.(3)66patients(86.8%) manifestated minor hemoptysis,including29cases(38.1%) with sputum with blood.6patients(7.9%) manifestatedmoderate hemoptysis.4patients(5.3%) manifestated massivehemoptysis,including2patients suspected IPH,1diagnosed tuberculosisand1patient considered bleeding from both aspiratory tract and digestivetract.74patients had cough and expectoration.23patients had fever.(4) Streptococcus pneumoniae(5cases), Moraxella catarrhalis(3cases) Haemophilus influenzae(3cases) and Staphylococcus aureus(3cases) were isolated from sputum of30cases with pneumonia.5patientswith tuberculosis had positive result in PPD test.9patients withtuberculosis were diagnosed by pathogen way. Hemosiderin-ladenmacrophages were found in sputum or gastric aspirate of14patients.23patients did fibreoptic bronchoscopy.All result showed acute or chronictracheal bronchial intimitis.37patients had anemia.(5)52patients were treated with hemostatic agents.Most of patientshad favorable response.24patients without hemostatic agents recovered.Conclusions(1) The incidence of hemoptysis has no significant difference between boys and girls.High incidence appears around5-year-old and13-year-old.(2) Respiratory tract infection disease is the most common cause ofhemoptysis.In our study, pneumonia is most,and tubercle bacillus is acommon pathogen. In noninfectious diseases, IPH is the major cause.bronchiectasia and foreign body aspiration are also causes.(3)Routine blood test should be done.Gastric-aspirate specimenssmears and cultures which are often negative are available diagnostic testfor pulmonary tuberculosis. Fibreoptic bronchoscopy which does help toincrease the positivity rate is indicated to identify source of bleeding. HighResolution Computed Tomography (HRCT) and enhanced CT serve as thevaluable screening techniquea.(4) Minor hemoptysis is managed symptomatically. The therapy of theunderlying disease should be initiated if a specific etiology is identified.Achild with massive henoptysis requires to stabilize the airways,maintainthe oxygenation,control blood loss and maintain sufficient blood volume.