Haemoptysis as the first presentation of COVID-19: a case report
Abstract Background Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that profoundly challenges healthcare systems all over the world. Fever, cough and fatigue are the most commonly reported clinical symptoms. Cas...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-020-01312-6 |
| _version_ | 1818198897070178304 |
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| author | Elise Peys Dieter Stevens Yannick Vande Weygaerde Thomas Malfait Laurens Hermie Philippe Rogiers Pieter Depuydt Eva Van Braeckel |
| author_facet | Elise Peys Dieter Stevens Yannick Vande Weygaerde Thomas Malfait Laurens Hermie Philippe Rogiers Pieter Depuydt Eva Van Braeckel |
| author_sort | Elise Peys |
| collection | DOAJ |
| description | Abstract Background Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that profoundly challenges healthcare systems all over the world. Fever, cough and fatigue are the most commonly reported clinical symptoms. Case presentation A 58-year-old man presented at the emergency department with acute onset haemoptysis. On the fifth day after admission, he developed massive haemoptysis. Computed tomography (CT) angiography of the chest revealed alveolar haemorrhage, more prominent in the left lung. Flexible bronchoscopy confirmed bleeding from the left upper lobe, confirmed by a bronchial arteriography, which was successfully embolized. Nasopharyngeal swabs (NPS) tested for SARS-CoV-2 using real-time polymerase chain reaction (RT-PCR) repeatedly returned negative. Surprisingly, SARS-CoV-2 was eventually detected in bronchoalveolar lavage (BAL) fluid. Conclusions Life-threatening haemoptysis is an unusual presentation of COVID-19, reflecting alveolar bleeding as a rare but possible complication. This case emphasises the added value of bronchoscopy with BAL in the diagnostic work-up in case of high clinical suspicion and negative serial NPS in patients presenting with severe symptoms. |
| first_indexed | 2024-12-12T02:13:10Z |
| format | Article |
| id | doaj.art-57ba01710da0443fbff6470ce997cf7a |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-12T02:13:10Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-57ba01710da0443fbff6470ce997cf7a2022-12-22T00:41:52ZengBMCBMC Pulmonary Medicine1471-24662020-10-012011410.1186/s12890-020-01312-6Haemoptysis as the first presentation of COVID-19: a case reportElise Peys0Dieter Stevens1Yannick Vande Weygaerde2Thomas Malfait3Laurens Hermie4Philippe Rogiers5Pieter Depuydt6Eva Van Braeckel7Department of Internal Medicine and Paediatrics, Ghent UniversityDepartment of Internal Medicine and Paediatrics, Ghent UniversityDepartment of Respiratory Medicine, Ghent University HospitalDepartment of Respiratory Medicine, Ghent University HospitalDepartment of Radiology, Ghent University HospitalDepartment of Respiratory Medicine, Sint-Lucas HospitalDepartment of Internal Medicine and Paediatrics, Ghent UniversityDepartment of Internal Medicine and Paediatrics, Ghent UniversityAbstract Background Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that profoundly challenges healthcare systems all over the world. Fever, cough and fatigue are the most commonly reported clinical symptoms. Case presentation A 58-year-old man presented at the emergency department with acute onset haemoptysis. On the fifth day after admission, he developed massive haemoptysis. Computed tomography (CT) angiography of the chest revealed alveolar haemorrhage, more prominent in the left lung. Flexible bronchoscopy confirmed bleeding from the left upper lobe, confirmed by a bronchial arteriography, which was successfully embolized. Nasopharyngeal swabs (NPS) tested for SARS-CoV-2 using real-time polymerase chain reaction (RT-PCR) repeatedly returned negative. Surprisingly, SARS-CoV-2 was eventually detected in bronchoalveolar lavage (BAL) fluid. Conclusions Life-threatening haemoptysis is an unusual presentation of COVID-19, reflecting alveolar bleeding as a rare but possible complication. This case emphasises the added value of bronchoscopy with BAL in the diagnostic work-up in case of high clinical suspicion and negative serial NPS in patients presenting with severe symptoms.http://link.springer.com/article/10.1186/s12890-020-01312-6COVID-19HaemoptysisAlveolar bleedingBronchoalveolar lavageCase report |
| spellingShingle | Elise Peys Dieter Stevens Yannick Vande Weygaerde Thomas Malfait Laurens Hermie Philippe Rogiers Pieter Depuydt Eva Van Braeckel Haemoptysis as the first presentation of COVID-19: a case report BMC Pulmonary Medicine COVID-19 Haemoptysis Alveolar bleeding Bronchoalveolar lavage Case report |
| title | Haemoptysis as the first presentation of COVID-19: a case report |
| title_full | Haemoptysis as the first presentation of COVID-19: a case report |
| title_fullStr | Haemoptysis as the first presentation of COVID-19: a case report |
| title_full_unstemmed | Haemoptysis as the first presentation of COVID-19: a case report |
| title_short | Haemoptysis as the first presentation of COVID-19: a case report |
| title_sort | haemoptysis as the first presentation of covid 19 a case report |
| topic | COVID-19 Haemoptysis Alveolar bleeding Bronchoalveolar lavage Case report |
| url | http://link.springer.com/article/10.1186/s12890-020-01312-6 |
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