Background : Hemoptysis is an alarming symptom. Etiologies variy according to many factors. In high burden countries of tuberculosis (TB), active TB and sequeale are remaining the major cause of hemoptysis. Our study aims to assess etiological and therapeutic features in patients hospitalized for hemoptysis in an endemic coutry of TB (Tunisia).

Methods : Cross sectional study carried out in the pulmonology department of the Rabta hospital. Adult patients hospitalized for hemoptysis regardless of its abundance were included. Patients with iatrogenic or traumatic hemoptysis, alveolar haemorrhage or extrarespiratory bleeding were not included. Demographic, clinical, paraclinical and therapeutic data were analyzed.

Results : 200 patients were included (mean age: 54±16.8 years, sex ratio: 3). Hemoptysis was of low, medium and high abundance in 60%, 34.5% and 5.5% respectively. Bronchial endoscopy helped locate bleeding in 63.1%. Chest scan helped to determinate etiology of the hemoptysis in 71% of cases. The main etiologies were lung cancer (17%), bronchiectasies (15.5%), active TB (12%) and TB sequelae (10.5%). Lung cancer was the most common cause of severe and recurent hemoptysis (p<0.05). Bronchial arterial embolization was performed in only 3.5% of cases. Surgery was necessary in 18  patients from whom 33% had TB sequelae. The mortality rate was 3.5% ; it was independant of the etiology.

Conclusion : Despite all the efforts in the fight against TB in Tunisia, this infectious disease remains the main etiology of hemoptysis. Additional efforts have to be made in order to prevent this serious complication.