Hemoptysis is a topic covered in the Select 5-Minute Pediatrics Topics.

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Hemoptysis is the coughing up of blood from the respiratory tract. The term comes from the Greek words haima, meaning blood, and ptysis, meaning spitting. The amount and nature of bleeding should be characterized by taking a careful history. Bleeding from the respiratory tract can range from blood-streaked sputum to massive hemoptysis from the lung. The source of bleeding can be anywhere in the respiratory tract, from the nose to the alveolus. Associated symptoms vary and may include cough, chest pain, rhinorrhea, or dyspnea, or there may be none. Consequences of hemoptysis may include exsanguination, hypoxemia, and anemia, or there may be none.


Large series of pediatric patients with massive hemoptysis have not been described. Most instances of massive hemoptysis take place in older children, usually with underlying cardiac or pulmonary conditions.


  • Related to the underlying pulmonary or cardiac disease
  • Vascular origin of hemoptysis is from 2 sites: Pulmonary arteries or bronchial arteries


  • Aspiration
  • Bronchiectasis
  • Bronchitis
  • Cavitary infections (e.g., tuberculosis, abscess, histoplasmosis)
  • Cystic fibrosis
  • Congenital vascular or airway lesions (pulmonary arteriovenous malformation, hemangioma, bronchogenic cyst)
  • Congenital heart disease with collateral vessels or pulmonary hypertension
  • Factitious hemoptysis
  • Foreign body aspiration
  • Hemorrhagic diathesis, including anticoagulant therapy
  • H-type tracheoesophageal fistula
  • Pneumonia
  • Pulmonary embolism
  • Pulmonary hemosiderosis
  • Tracheostomy-related complications
  • Trauma (pulmonary contusion, bronchoscopy, airway manipulation)
  • Tumors (lymphomas)

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