Introduction  

The blood-gas barrier must be very thin to allow gas exchange and it is therefore subjected to high mechanical stresses when the capillary pressure rises. Exercise-induced pulmonary hemorrhage (EIPH) occurs frequently in horses and there is evidence that EIPH can also occur in humans.

Materials and methods  

We reported on a healthy 65-year-old male who developed a diffuse alveolar hemorrhage (DAH), like an EIPH, after playing saxophone for 6 h continuously. There were hemoptysis, crackles breathing sounds on exam, and bilateral radiographic infiltrates. A high-resolution computed tomographic study of the thorax disclosed DAH, the presence of which was proved by a gross appearance of bilateral bronchus on bronchoscopy and histopathological study of bronchoalveolar lavage material.

Conclusion  

This is the first report of alveolar hemorrhage caused by playing saxophone. In our case, he presented with a benign course and regressed spontaneously without any medical intervention.