Can blood in sputum be due to a parasite infection?

Question

Hi doctor,

I am writing as I found something in my mom's sputum (parasite or blood) that I cannot identify. I have images on a 1:1 ratio and also magnified. She had chronic diarrhea and dermatitis. She responded well to Niacin. Her diarrhea is only occasional now. She is anorexic, fatigued, and very frail. She refuses most meals and has food fads (at one point she was only wanting ice cream).

She is very restless and unable to sleep for long. She looks pale and a bit restless. She has no motivation. She is not reporting any abdominal pain. She is very flatulent. We have to make sure all her food is very soft. She complains of things getting stuck between her teeth. She has not seen a dentist in decades.

She seems to dab her saliva often, although her mouth looks dry. I asked her to rinse her mouth and spit again, but it did not elicit more of these things. Her breathing is normal. I wanted help identifying the organisms in her sputum. History of medical conditions: History of alcohol abuse, but currently not taking alcohol. She had extreme weight loss gradually over the years, and she is 85 years old. Current medication details: No medications.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern and will definitely help you regarding it. I have seen all the attached images (the attachment removed to protect the patient's identity). In the first two images, it actually seems like a blood clot. However, in the last two of them, specific beads give it a shape that makes it difficult to label as a blood clot, but it does not fit the description of a common parasite either.

I suggest you submit it for a laboratory microscopic examination for a definitive diagnosis. A raised eosinophil count on blood work will point toward a parasitic infestation. On the other hand, a raised neutrophil count and ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein) will point towards lung infection, which can cause blood to appear in sputum. I wanted to ask whether she actually coughed up sputum (which means it came from the lower respiratory tract).

Or was it just in saliva? Talking about the difficult lifestyle of your mom, as you said, she responded to Niacin. I would like to tell you that niacin deficiency also causes a condition called dementia, which results in loss of cognitive functioning, as evidenced by the symptoms you mentioned. A complete blood count can reveal anemia (the cause of the appearance of pale skin). A complete physical examination is necessary at this stage, as the symptoms are very diverse. An ultrasonographic examination may also be required. Once all the organic causes are excluded, a search for psychomotor causes will be done.

I hope this helped, please take care.