Q. The patient has breathing difficulty and is coughing up blood. What should be done?

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 04, 2020

Hi doctor,

The patient is experiencing breathing difficulty, which relieves by inhaler, and O2 saturation is 93 to 95. The patient coughs out phlegm with blood and has no fever. He is negative for COVID-19 and TB. He has pain in the back and right arm. I want someone to reread the CT scan. He has a previous history of pneumonia progressed empyema. He had surgery in VATS with decortication in the right lung. I am currently taking Hemostan with Guaifenesin, Arcoxia, Salbutamol inhaler, and Sinecod.



Welcome to

Thanks for the query. I can understand your concern. According to your statement, you have been suffering from difficulties breathing, productive cough with phlegm, and blood. Your HRCT (high resolution computed tomography) of the chest has shown a mass-like consolidation in the right lower lobe with surrounding ground-glass densities, suggestive of bronchial carcinoma. Your COVID-19 test is negative; the MRB gene expert test is negative. Usually, mass-like consolidation may result from pneumonia caused by viruses, bacteria or yeast infection, bronchial carcinoma, TB (tuberculosis), etc. It would help if you underwent CT (computed tomography) guided FNAC (fine needle aspiration cytology) or biopsy from the right lower of the lung may confirm the exact underlying causes for consolidation and then treat them accordingly. Your physical history of previous diseases, symptoms of night sweats, weight loss, fever, etc. also very important. Take care. I hope I have answered the questions. Let me know if I can assist you further.

Hi doctor,

Thank you for your response.

I am not sure if CT and FNAC are available here. Our doctor said he would do bronchoscopy so he can check the lungs inside. Is that needed? His O2 saturation now is 93 only.



Welcome back to

Thanks for joining us again. For confirming the diagnosis, CT guided FNAC or biopsy is needed. Please consult with the physician; he can refer to the higher center where it is available. Yes, do as your doctor wants. By bronchoscopy, he can check the lungs inside, and if possible, he can collect biopsy from the lesion, so do everything according to your doctor's advice. Here, oxygen saturation is not so important. Firstly, the diagnosis of disease should be done and then treat them accordingly. Without proper diagnosis, treatment is not possible. In case of any other query, ask me.

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