Cough and hemoptysis in a middle-aged woman

摘要

A 44-year-old woman with a 3-month history of cough and more recent hemoptysis was admitted to the respiratory ward at the affiliated hospital of Nantong University. Her cough had not responded to empiric antibiotic therapy. One week prior to admission, she noted worsening of the cough and development of hemoptysis. For the prior half year, she had frequent mild aches in the lower limbs and minor swelling of knee joints. She denied fevers, chills, chest pain, night sweats, weight loss, or loss of appetite. The patient was a nonsmoker and denied use of alcohol, illicit drugs, or exposure to toxins. Her family history was negative. Prominent physical findings included decreased respiratory sounds and rales in the right lung, and digital clubbing of fingers (fig. 1).