Background: Haemoptysis, coughing up blood from the respiratory tract distal to the vocal cords, is a rare symptom in children, and the cause is difficult to determine. The symptom can cause anxiety for the child, parents and treating physician.
Case description: We describe two cases of adolescents who presented at the Accident and Emergency Unit with acute onset dyspnoea and haemoptysis. In patient A, the haemoptysis was caused by tuberculosis, a known but rare cause of haemoptysis in the Netherlands. Patient B was found to have pseudohaemoptysis, which always has to be differentiated from haemoptysis.
Conclusion: Although haemoptysis in children is usually mild and self-limiting, knowledge about the possible underlying causes and necessary diagnostic workup is essential in order to reach the right diagnosis promptly and start appropriate treatment in case of life threatening haemoptysis.