Severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection

BMC Pulm Med. 2020 Sep 14;20(1):244. doi: 10.1186/s12890-020-01285-6.

Abstract

Background: Since the beginning of SARS-CoV-2 outbreak in China, severe acute respiratory syndrome has been widely descripted. Hemoptysis has rarely been observed in SARS-CoV-2 infection. We report here a case of severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection and managed in a referral center.

Case presentation: A 58-year-old man was admitted to our intensive care unit for severe hemoptysis with history of post-tuberculosis bronchiectasis. At ICU admission the patient had fever and severe acute respiratory failure requiring high flow oxygen therapy. Respiratory tract sampling was positive for SARS-CoV-2. Multi-detector computed tomography angiography pointed out localized bronchiectasis on the left lower lobe and enlarged left bronchial and phrenic arteries; bronchial arteriography with distal embolization was performed with favorable outcome and no bleeding recurrence.

Conclusions: To our knowledge, this is the first case of acute exacerbation of bronchiectasis related to SARS-CoV-2 infection and complicated by severe hemoptysis. Whether the virus may play a role in the dysregulation of airway haemostasis, and contribute to episodes of hemoptysis in patients with chronic pulmonary diseases and predisposing factors might be investigated.

Keywords: Bronchiectasis; Case report; SARS-CoV-2; Severe hemoptysis.

Publication types

  • Case Reports

MeSH terms

  • Bronchiectasis / complications*
  • COVID-19
  • Coronavirus Infections / complications*
  • Hemoptysis / etiology*
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Severity of Illness Index
  • Tuberculosis, Pulmonary / complications*