RESUMO
"Hemoptysis" refers to the expectoration of blood from the respiratory tract. However, "life-threatening hemoptysis" includes any volume that leads to features such as airway obstruction, hypoxia, or hemodynamic instability. We present a case of life-threatening hemoptysis in a 65-year-old male with a history of benign prostatic hyperplasia and uncontrolled hypertension. Radiological investigations revealed a pseudo-aneurysm at the site of a prior thoracic aortic coarctation repair more than 50 years prior in childhood. He required vascular surgical intervention, during which there was evidence of an aorta-bronchial fistula as the likely cause of bleeding. Following the repair and optimal blood pressure control, the patient had no further episodes of hemoptysis and was discharged from the hospital. His case not only adds to the growing body of medical literature reporting hemoptysis as a complication of coarctation repair but also highlights the aorto-bronchial fistula as a possible and potentially catastrophic mechanism for bleeding in these patients.
RESUMO
Acute eosinophilic pneumonia (AEP) is a rare but severe respiratory syndrome characterized by fever, hypoxemic respiratory failure, diffuse pulmonary infiltrates, and pulmonary eosinophilia. The most common cause of AEP is idiopathic, but it can be associated with antidepressant medications like sertraline. A 76-year-old female presented to our ED with acute hypoxemic respiratory failure. She had no history of smoking or prior lung disease. She did not improve after treatment with broad spectrum antibiotics so a trial of corticosteroids was initiated. Her work-up was negative for infectious or collagen vascular causes of the respiratory failure. She was diagnosed with AEP associated with sertraline. Her condition improved with corticosteroid therapy after discontinuation of sertraline. This case report highlights AEP as a possible adverse reaction of sertraline. Prompt discontinuation of the offending drug is necessary for early recovery.