We talked about a very interesting case of hemoptysis due to bronchiectasis. 

  1. When thinking about confirmed hemoptysis you can think about the possible etiologies based on anatomy.  Bronchial Tree (tumor, bronchitis, bronchiectasis), Parenchyma (PNA, TB, GPA or Good Pastures) and Vascular (PE, CHF, AVM, Mitral Stenosis).

  2. When thinking of the causes of bronchiectasis consider the causes based on the distribution of the disease. 

    1. Upper Lobe Predominant:

      1. CF

      2. Connective Tissue Dz

      3. ABPA

    2. Middle Predominant:

      1. MAC

    3. Lower Lobe Predominant:

      1. Aspiration

      2. Recurrent Infections (consider immunodeficiency)

      3. End stage fibrotic lung disease

    4. Central Predominant:

      1. Ciliary Dyskinesia

    5. Isolated:

      1. 2/2 Radiation

  3. Want to learn more about bronchiectasis? Consider Dr. Barker’s NEJM paper on bronchiectasis.