A NewCauseof FungusBall

Although our diagnosis of pulmonary hemorrhage was one ofexclusion, Ewan and associates4 have elegantly shown that measurement of carbon dioxide uptake can be a very sensitive and specific indicator of acute pulmonary hemorrhage. Unlike other alveolar filling processes, alveolar hemorrhage is associated with an increase in carbon monoxide uptake by the lung because of binding of the carbon monoxide to the erythrocytes in the alveoli with a decrease in delivery of carbon monoxide to the arterial blood. This results in an increased ratio ofpulmonary uptake to clearance ofcarhon monoxide.�