Rivaroxaban
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Haemoptysis: case report A 58-year-old man developed haemoptysis during treatment with rivaroxaban for pulmonary embolism [duration of treatment to reaction onset not stated]. The man was admitted to ICU for severe heamoptysis. His medical history was significant for post-tuberculosis bronchiectasis and had episodes of heamoptysis 3 years prior to the presentation which resolved with unspecified medical measures. He had been receiving oral rivaroxaban for pulmonary embolism diagnosed within the 2 preceding months [dosage not stated]. Three days prior to the admission, he developed cough, shortness of breath, fever, asthenia, myalgia and increased expectoration. He had reported a contact with a colleague who had been tested positive for SARS-CoV-2. At the time of admission, he had acute massive haemoptysis (>200ml) with increased dyspnoea. A multi-detector CT angiography showed poorly defined disseminated centrilobular nodules along with localised bronchiectasis in the enlarged left bronchial arteries, left lower lobe and phrenic arteries. On admission, he had fever and acute respiratory failure which required high flow oxygen therapy. Respiratory tract sampling was positive for SARSCoV-2. The anti Xa activity was 20 ng/mL. The man underwent bronchial arteriography with distal embolisation of both phrenic and left bronchia arteries. Thereafter, bleeding did not recur. He had no complications of the vascular intervetional procedure. On day 14, he was discharged from hospital. Lopinto J, et al. Severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection. BMC Pulmonary Medicine 20: 14 Sep 2020. Available from: 803507028 URL: http://doi.org/10.1186/s12890-020-01285-6
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Reactions 17 Oct 2020 No. 1826
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