What is the severity of tuberculosis coughing up blood?

The issue that many tuberculosis patients are most concerned about is the severity of their coughing up blood. In fact, it is impossible to judge the severity of tuberculosis based on the coughing up blood, because tuberculosis patients can cough up blood when their condition worsens, they can also cough up blood when their condition improves, and even after they recover. So what are the causes of tuberculosis patients coughing up blood? Let's take a closer look!

(1) The permeability of capillary walls increases . Due to the inflammatory reaction of tuberculosis lesions and the stimulation of toxins on the capillary walls, the permeability of the capillary walls is increased, and red blood cells extravasate into the alveoli, resulting in blood in the sputum or blood-stained sputum.

(2) Lesions erode blood vessels: When tuberculosis lesions progress or caseous necrosis and dissolution occur, causing erosion and destruction of blood vessels, moderate or fatal hemoptysis may occur. Sometimes it is not the lesion that directly erodes the blood vessels, but the blood vessels are suddenly ruptured by external factors such as severe coughing, excessive chest expansion, etc. on the basis of being damaged by the lesion. The ruptured bleeding of the pulmonary artery is dark red and the amount of bleeding is large. The pressure in the bronchial artery is 6 times that of the pulmonary artery, and the bleeding is severe. Sometimes, due to its good elasticity and strong contractility, hemoptysis will stop suddenly.

(3) When pulmonary tuberculosis is complicated by bronchial tuberculosis, the mucosal wall of the tube is damaged, eroded, ulcerated and prone to bleeding, usually with blood in the sputum or a small amount of hemoptysis.

(4) In some patients, during the process of cavity formation , blood vessels on the cavity wall form aneurysms. If the lesion further erodes the aneurysm or if the blood vessel pressure increases during severe coughing, the aneurysm may rupture and cause massive hemoptysis.

(5) Tuberculosis complicated by bronchiectasis and hemoptysis.

(6) Tuberculosis patients suffer from coagulation disorders causing hemoptysis.

(7) Female tuberculosis patients with replacement menstruation (including endometriosis) are characterized by hemoptysis before each menstrual period.

(8) Hemoptysis caused by irritation of calcification or contraction of fibrous scar.

(9) During treatment, as tuberculosis bacteria are killed, the body's healing ability is enhanced, the lesions are gradually absorbed, the cavities gradually close, and are replaced by new lung tissue. Because the newly formed lung tissue contains a very rich number of capillaries, if the tuberculosis patient exercises excessively or coughs violently at this time, the blood vessels may be ruptured and hemoptysis may occur.

(10) Drug-induced hemoptysis . Certain drugs used during chemotherapy, such as thiosemicarbazide which causes thrombocytopenia and sodium para-aminosalicylate which inhibits the liver's production of prothrombin, can cause hemoptysis, but most of the time it is bloody sputum.

(11) Aspergillus infection: When patients with cavitary pulmonary tuberculosis are infected with fungi, aspergillus balls form in the cavities, irritating the blood vessels in the cavity wall and causing the patients to repeatedly have blood in their sputum or hemoptysis.