Korean J Crit Care Med.  2015 Feb;30(1):31-33. 10.4266/kjccm.2015.30.1.31.

Diffuse Alveolar Hemorrhage Confirmed by Bronchoalveolar Lavage in a Patient with Hemoptysis after Sildenafil Use for Erectile Dysfunction

• Moon KM
• Jung SY
• Han MS
• Cho Y
• Rah YM
• Kim JW

• KMID: 2227698
• DOI: http://doi.org/10.4266/kjccm.2015.30.1.31

Abstract

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.

Keyword

bronchoalveolar lavage; hemoptysis; pulmonary hemorrhage; sildenafil

MeSH Terms

Acinetobacter baumannii
Aged, 80 and over
Anti-Bacterial Agents
Bronchoalveolar Lavage*
Emergency Medical Technicians
Erectile Dysfunction*
Hemoptysis*
Hemorrhage*
Humans
Intensive Care Units
Lung
Male
Pneumonia
Prescriptions
Respiratory Insufficiency
Sepsis
Tranexamic Acid
Ventilators, Mechanical
Sildenafil Citrate
Anti-Bacterial Agents
Tranexamic Acid

Figure

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  Fig. 1. Chest computed tomography shows multifocal diffuse ground-glass attenuation and patchy consolidation in both lungs.

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  Fig. 2. Bronchoalveolar lavage (BAL) was done in the left lower lobe. And we can find the progressive hemorrhagic BAL in the serial samples (Number 1 is the first BAL, number 2 is the second BAL, and number 3 is the third BAL.). BAL fluid analysis shows an increase in red blood cells.

Reference

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