Aidan O'Brien

Curious bloody sputum causes concern

A 62-year-old man came to the medicine service after a week of progressively worsening hemoptysis. His history was significant for chronic sinusitis, the symptoms of which had increased . in severity in the week before admission. Red-purple, raised lesions had recently developed on his legs, and over the last month, he had symptoms of arthralgia and myalgia, plus a 10-lb weight loss. No fever or night sweats were present, but he did become dyspneic with exertion. Interestingly, he had had a positive purified protein derivative test 2 years before admission, but a chest film made at that time was clear. He had no history of alcohol or cigarette use.