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Acute COPD exacerbation presenting with pronounced intrabullous haemorrhage and haemoptysis
  1. Daniel Runggaldier1,
  2. Taro Minami2,3,
  3. Daniel Golding3,4,
  4. Kamran Manzoor2,3
  1. 1Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
  2. 2Division of Pulmonary, Critical Care and Sleep Medicine, Memorial Hospital of Rhode Island, Providence, Rhode Island, USA
  3. 3Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
  4. 4Department of Radiology, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA
  1. Correspondence to Dr Daniel Runggaldier, daniel.runggaldier{at}


A 54-year-old man with history of chronic obstructive pulmonary disease (COPD) presented with subacute onset of chest pain, shortness of breath, productive cough with haemoptysis and night sweats. There were no fever or recent weight loss reported. The chest radiograph showed right upper lobe bullae with adjacent opacification and an emphysematous lung. Due to worsening haemoptysis and persistent chest pain, CT of the chest with contrast was performed, which revealed moderate to severe emphysema and numerous blood-filled bullae. Cardiac work-up for chest pain was negative for myocardial ischaemia and for aortic dissection. Further infectious work-ups for mycobacterial and invasive fungal infection were negative. The patient was treated for acute COPD exacerbation and responded well to the antibiotics with the resolution of haemoptysis. Follow-up CT of the chest revealed the gradual resolution of the haemorrhage, while the patient remained asymptomatic.

  • tobacco related disease
  • pulmonary emphysema
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  • Contributors DR: writing of manuscript, analysis and evaluation of X-ray and CT images. TM and KM: editing of manuscript, analysis and evaluation of X-ray and CT images, patient care. DG: editing of manuscript, analysis and evaluation of X-ray and CT images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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