🫁 Haemoptysis in Aspergillosis: A Complete Patient Guide

1. 🌡 What Is Haemoptysis?

Haemoptysis means coughing up blood from the lungs. It might appear as:

• Specks or streaks of blood in your sputum

• Bright-red frothy sputum

• Clots or large quantities of fresh blood  aspergillosis.org/haemoptysis/

It’s common in conditions like chronic pulmonary aspergillosis (CPA) and sometimes in ABPA.

2. 🚨 When to Worry: Recognising Emergency Bleeding

Call 999 or go to A&E immediately if you experience:

• More than 1 tablespoon (~15 ml) of fresh blood in one episode aspergillosis.org/haemoptysis/

• Bright-red, continuous bleeding

• Feeling breathless, dizzy, or faint

• Any sudden change in pattern or amount of bleeding    aspergillosis.org/managing-life-with-haemoptysis/

Massive haemoptysis is defined as ≥150 ml in 1 hour or ≥600 ml in 24 hours .

3. 🏥 What Might Happen in Hospital

In more severe cases, you may receive:

• Oxygen therapy, blood or fluid transfusion

• Bronchoscopy to localise or control the bleed

• Bronchial artery embolisation (BAE) guided by CT

• Possible intubation if breathing is significantly compromised

• Rarely, surgery or radiotherapy if bleeding persists  aspergillosis.org/haemoptysis/

4. 🗓 Aftercare and Monitoring

Regular follow-up is essential:

• Repeat chest CT to check healing or detect new issues

• Sputum cultures, specifically for Aspergillus, TB, NTM

• Blood tests for Aspergillus IgG/IgE ± galactomannan

• Clinic review to adjust antifungal therapy, embolisation, or airway clearance

5. 💊 Medications & Prevention

• Tranexamic acid reduces bleeding and is prescribed short-term aspergillosis.org/haemoptysis/

• Antifungals (itraconazole, voriconazole) for CPA/aspergilloma

• Steroids ± antifungals for ABPA

• Encourage adherence to antifungal/antibacterial treatments

6. 🏡 Practical Advice at Home

• Keep room air at moderate humidity, avoid dust, smoke, strong odours aspergillosis.org/managing-life-with-haemoptysis/

• Stay hydrated, use warm teas or soups to soothe airways aspergillosis.org/managing-life-with-haemoptysis/

• Avoid nebulisers or airway clearance devices until OK’d by your specialist

• Sleep propped-up, not flat, with slight elevation or on the affected side only if firmly advised

• Maintain a rescue pack at home: tissues, water, mouth lozenges, emergency plan

7. 🧘 Reducing Cough & Airway Irritation

• Practice gentle breathing techniques (pursed-lip, diaphragmatic, nasal breathing)

• Use lozenges or warm honey drink for throat soothing

• Consider mild codeine or inhaled tranexamic acid if prescribed

• Avoid cough triggers (hot steam, cold air, vapours)

8. 🆘 Be Prepared: Know Your Plan

• Carry a medical alert card (e.g., NAC wallet card) explaining your condition to paramedics

• Keep a written chart of your medications, dosages, and emergency numbers

• Remove air filters or masks if they are dusty/mouldy — otherwise continue using HEPA systems

9. 😌 Emotional & Psychological Support

• Anxiety and fear of rebleeding are normal — grounding techniques, breathing exercises, and coping strategies help aspergillosis.org

• Join support groups to share experiences — Aspergillosis.org has active patient forums

10. 📌 What You Should Ask Your Specialist

• What was the confirmed or suspected cause (CPA, aspergilloma, ABPA, infection)?

• Are repeat scans or bronchoscopy needed?

• Is my current antifungal or antibiotic strategy sufficient?

• What is the safest way to reintroduce airway clearance or nebulizers?

• Should I have a bronchial artery embolisation or surgery?

• How and when can I resume daily activities, including physiotherapy?