Hemoptysis

Common causes of hemoptysis include the following:
• Acute infections (e.g., exacerbations of COPD).
• Bronchiectasis: can be responsible for massive hemoptysis.
• Bronchial carcinoma: secondary deposits and benign tumors can also lead to hemoptysis but are less common.

• Pulmonary tuberculosis: a common cause worldwide.
• Pulmonary embolus with infarction.
• Left ventricular failure can lead to the production of pink, frothy sputum.
• Mitral stenosis.
• Other infections, such as lobar pneumonia ("rusty" sputum) or, less commonly, lung abscess.
• Trauma (e.g., contusions to the chest, inhalation of foreign bodies, or after intubation).
Rare causes of hemoptysis include the following:
• Bleeding diatheses.
• Vasculitis (e.g., Goodpasture's syndrome and Wegener's granulomatosis).
• Diffuse interstitial fibrosis.
• Idiopathic pulmonary hemosiderosis.
• Arteriovenous malformations (Osler-Weber-Rendu disease [hereditary hemorrhagic telangiectasia], a favorite in exams but rare in practice).
• Eisenmenger's syndrome.
• Sarcoidosis and amyloidosis.
• Primary pulmonary hypertension.
• Cystic fibrosis.
• Invasive aspergillosis.
Note that in up to 15% of cases no cause for hemoptysis is found.