TY - JOUR T1 - An incidental finding in a 34-year-old male under investigation for haemoptysis JF - European Respiratory Journal JO - Eur Respir J SP - 1227 LP - 1229 DO - 10.1183/09031936.00131908 VL - 33 IS - 5 AU - D. Pinot AU - D. Breen AU - J-M. Peloni AU - J-Y. Gaubert AU - H. Dutau AU - D. Vervloet Y1 - 2009/05/01 UR - http://erj.ersjournals.com/content/33/5/1227.abstract N2 - A 34-yr-old male presented with a 1-week history of a productive cough associated with small volume haemoptysis. This was preceded by a 3-month history of a chronic nonproductive cough and 6 kg weight loss. He denied chest pain, fever or night sweats. He admitted to increasing fatigue, but denied arthalgia, myalgia or skin rash. His past medical history was noncontributory. The patient worked in the construction industry and smoked 20 cigarettes per day. He admitted to illicit drug usage, both cannabis and cocaine on a regular basis. On examination, he was afebrile and haemodynamically stable. There was evidence of recent weight loss. His respiratory rate was 18 breaths·min−1 and oxygen saturations were 99% in room air. Lung examination was unremarkable. Laboratory examination included the following: white blood cell count 8.28 g·L−1 with 43% neutrophils; haemoglobulin 16.3 g·L−1; haematocrit 47%; erythrocyte sedimentation rate 1 mm in the first h and C-reactive protein 1.55 mg·L−1. The results of renal function tests and biochemistry were within normal limits. Sputum specimens for culture and sensitivity and total blood count were negative. A plain chest radiograph and computer tomography (CT) of the thorax were performed (fig. 1a–c⇓). Further investigations including α1 antitrypsin, pulmonary function and bronchoprovocation tests were normal. Oral examination and gastroscopy were within normal limits and did not reveal any source of bleeding. A bronchoscopy was performed (fig. 1d⇓) and aspirates demonstrated a positive culture of Haemophilus influenzae, which was sensitive to amoxicillin.Fig. 1— a) A chest radiograph, b and c) computed tomography images at the level of the trachea and d) endoscopic view of the trachea at … ER -