Question: A malnourished 59 year old male with a T4 base of tongue squamous cell carcinoma is hospitalized for electrolyte disturbances secondary to re-feeding syndrome. He is tracheostomy tube dependent due to tumor-related obstruction of his supraglottic airway. In the absence of any upper airway instrumentation, he develops bright red hemoptysis that resolves spontaneously. Tracheoscopy does not reveal a source distal to the subglottis. Review of his CT scan demonstrates several areas of tumor ulceration in proximity to branches of the external carotid system. What is your next step for his hemoptysis? [Answer will be posted with next week's new question]
Answer to last week's question, This Is Spinal Tap (February 1, 2016):
Meningitis (whether viral or bacterial) may raise intracranial pressure and create a transient CSF leak that resolves with appropriate meningitis treatment.