Bloody foamy sputum is a foamy sputum containing a large amount of blood. The sputum is red in color. Large amount of foamy sputum can be seen in pulmonary aspergillosis (sputum can smell like wine); pink foamy sputum is seen in pulmonary edema, etc. Chronic lung abscess, bronchiectasis, etc. can also have foamy sputum. What can cause pulmonary aspergillosis? 1, Aspergillus fumigatus (30%) Pulmonary aspergillosis (pulmonaryaspergillosis) is mainly caused by Aspergillus fumigatus (aspergillusfumigatus). The bacterium is parasitic in the upper respiratory tract and can only cause disease when the immunity of the body is reduced in patients with chronic diseases. 2, inhalation of Aspergillus spores (20%) Aspergillus spores everywhere in the air, in autumn and winter and rainy season, when the stored cereal grass is hot and moldy more. Inhalation of Aspergillus spores does not necessarily cause disease, a large number of inhalation to cause acute trachea – bronchitis or pneumonia. The disease is often secondary to existing diseases of the lungs, such as bronchial cysts, bronchial dilatation, pneumonia, lung abscess, etc.. The endotoxin of Aspergillus causes tissue necrosis and the lesions are infiltrative, solid, peribronchiolitis or cornified diffuse chronic lesions. Patients with Aspergillus do not have significant systemic symptoms, but have derriere hemoptysis and cough. Isolated spherical foci of crescentic translucent areas in the lungs are typical of their X-shaped presentation. ABPA generally occurs on an atopic basis, presenting with recurrent episodes of wheezing, fever, cough, coughing up brown sputum clots, and hemoptysis. Physical examination shows croup in both lungs and fine wet rales in the lung infiltrates. Chest X-ray shows infiltrative lesions distributed in lobes and segments of the lungs, often wandering; solid lung lesions, or segmental or lobar atelectasis due to mucus embolization of the bronchi, then no interlobular fissure displacement, long-term recurrent attacks may lead to central bronchial dilatation, the affected segment or subsegmental bronchi are cystically dilated, while the distal end is normal. Track-like, parallel, ring-like, band-like or toothpaste-like, finger-loop-like shadows are also often seen. Blood eosinophilia is increased. Serum IgE concentration is elevated. The intradermal test with Aspergillus leachate may show a biphasic reaction: after 15-20 minutes of test, wind and redness reactions appear and subside about 0.5-2 hours (type I reaction); after 4-10 hours of re-observation, Arthus reaction appears locally in the skin test and subside about 24-36 hours (type III reaction). Patients containing Aspergillus-specific precipitins, measured with concentrated serum specimens, had a positive rate of 92%. Patients with IPA are severely ill. There was fever, cough, coughing purulent sputum, chest pain, hemoptysis, dyspnea, and corresponding signs and symptoms caused by dissemination to other organs. Physical examination reveals dry or wet rales in the lungs, and early X-rays may show limited or bilateral multiple infiltrates, or nodular shadows, which often rapidly expand and fuse into solid necrosis to form a cavity; or sudden onset of large, wedge-shaped shadows with the bottom edge facing the pleura, resembling a “mild” pulmonary infarction. Rarely, there are signs of pleural effusion.