Case report: A 55-year-old malnourished man presented with hemoptysis. He was a known case of brittle insulin dependent diabetes mellitus and pulmonary tuberculosis (TB) and had undergone a full course of medical therapy for the TB 3 years back. The hemoptysis was of 2 weeks duration and increasing in the volume of blood brought out. Investigations (Chest X-Ray, CT Chest, and bronchoscopy) revealed a left upper lobe cavity with blood seen in the left upper lobe on bronchoscopy.
The patient was very weak weighing just 32 Kg (height 5ft 6in, BMI 11.39). His HBA1C was 8.2 % and he was started on continuous IV insulin therapy after admission and a high protein diet under the care of a diabetologist and a dietitian. While in the hospital he had another bout of massive hemoptysis. His coagulation profile was within normal limits with a low hemoglobin of 8 gm/dl (before the current…
