Massive haemoptysis in the acquired immunodeficiency syndrome

A 32-year-old male intravenous drug abuser was admitted to our institution with constitutional symptoms and sputum smears containing acid-fast bacilli, but no parenchymal disease on chest radiograph. He subsequently developed massive haemoptysis and required an emergency lobectomy. The pathology specimen revealed miliary tuberculosis with extensive caseation, schistosomiasis and cytomegalovirus. This is the first report of massive haemoptysis in the acquired immunodeficiency syndrome. The severe pulmonary haemorrhage was most likely due to miliary tuberculosis.