Blood in the sputum

Question

Hello dear expert team,
my son is 8-years-old and suffers from CF, he has blood in the sputum since Thursday.
On Thursday he has been discharged from hospital after 14 days of i.v. therapy, he had a pneumonia. It happens up to 8 times and sometimes it is streaked with blood and sometimes there are real mucus plugs of blood. What can this be?

Answer

Hello,
you report that you observe at you 8-year-old son, streaking of blood of the sputum in varying grades of severity. Sometimes the sputum is only streaked with blood, sometimes you observe bloody mucus plugs, that are coughed out. Due to a pneumonia, your son has been treated for 14 days in hospital with i.v. antibiotic drugs and you have observed the blood in the sputum for the first time at the day of discharge.
Small amounts of blood in the sputum are not seldomly observed in CF patients in the frame of a severe pneumonia. It comes to such admixtures of blood if small vessels in the bronchi (small lung arteries) become leak in the frame of the inflammation and then small amounts of blood mix up with the sputum. As blood is a very intense colorant, such an admixture of blood appears quickly really threatening, as frequently the whole sputum, that is coming out when coughing, is colored with blood. In general, such a first admixture of blood is only of short duration and the source of the bleeding is closing by itself quite quickly.
In order to accelerate the process of closing, it is recommended, to interrupt the inhalation with mucolytic drugs like e.g. Pulmozyme®, for a short time. Additionally one can take cough suppressing drugs like e.g. codein containing drugs. In any case, you should contact your CF center and discuss with the physicians, what should be done in the acutal case.
Such an event is in general not dangerous, however it underlines, that the preceeding pneumonia has been quite severe.
We wish you and your son all the best.

Yours sincerely,
Dr. H.-G. Posselt

08.07.2014

8.7.14 Please find more information on this under:

ecorn-cf.eu/index.php?id=65&L=8&tx_expertadvice_pi1%5Bshowitem%5D=1596&tx_expertadvice_pi1%5Bsearch%5D=lung%20bleeds


D. d'Alquen