Coughing up blood, also called hemoptysis, can have many causes. It can be a sign of a serious medical condition. Some possible causes of hemoptysis include chronic bronchitis or bronchiectasis, COPD (chronic obstructive pulmonary disease), lung cancer, tuberculosis, drug use, such as crack cocaine, parasitic infection, etc. So, if you're coughing up blood, you need to see a doctor immediately.
Recently, doctors at Max Super Specialty Hospital Vaishali removed a large fungal ball from the right lung of a young gentleman who had been coughing up blood. The patient, named Kumar, had been diagnosed with pulmonary tuberculosis in 2018. Even after completing the full course of the treatment, he experienced severe episodes of hemoptysis in the recent months. The doctors performed a rare surgical procedure called lung lobectomy to save his life.
Post treatment sequelae of lung tuberculosis
Kumar was initially treated with antibiotics when he first suffered from an episode of hemoptysis three months back, to which he responded well. But gradually, in the last month, he started coughing up a large amount (cup full) of blood on three occasions requiring immediate medical attention. CT scan revealed a large fungal ball in his right lung's lower lobe. A fibreoptic bronchoscopy (looking into airways through a scope) confirmed continued bleeding from the lower half (lobe) of the right lung, endangering his life. The biopsy results also confirmed the presence of a fungal ball.
It was then the team of doctors from Thoracic surgery clinic at Max Hospital Vaishali decided to perform lung lobectomy. This was a life-threatening situation, as the fungal ball can not only hamper the functioning of the very area of the particular lung but can also choke and prevent the functioning of the normal parts of the lungs as well, the doctors said.
"Such cases of hemoptysis can be life threatening and those with/ recovered from TB need to be extra cautious because even after successful treatment of lung tuberculosis, the person might suffer from its sequalae even after years. Seeking timely treatment is the only way to prevent fatality and thus timely consultation to a thoracic / lung surgeon is the key," noted Dr Pramoj Jindal, Director and Head of Department, Thoracic & Robotic Thoracic Surgery, Max Super Specialty Hospital, Vaishali.
Kumar was successfully operated, and the diseased lung lobe was removed, during a three hour long complex surgery. Post operatively, he was kept in the ICU for observation where he made a swift recovery and was then shifted to room the very next day, but under close monitoring. He underwent a physiotherapy course too so that he can return to all normal activities and was discharged after four days in a fit condition. With successful control of the source of bleeding along with adjunct medicine for fungal and bacterial infection, he has recovered well. He is expected to live a healthy long life and he will be on regular follow-up, the hospital said in a release.
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Tuberculosis cases in India
The rising incidents of pulmonary diseases, an alarming rate tuberculosis in India and the fact that millions are being diagnosed with Interstitial lung Diseases (ILD), are a matter of great concern the doctors pointed out.
"Despite being preventable and curable disease, tuberculosis even after treatment can showcase prominent symptoms which, if not diagnosed and treated timely, can prove fatal," said Dr Sharad Joshi, Associate Director - Pulmonology at Max Hospital, Vaishali.
By sharing this case of Kumar, Dr Joshi said they want to sensitize the public about TB and its possible post treatment sequelae, which can make the condition more complicated than before.