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Blood-Tinged Sputum

Sputum, or phlegm, is a mixture of saliva and mucus that you’ve coughed up. Blood-tinged sputum occurs when the sputum has visible streaks of blood in it. The blood comes from somewhere inside of your body, either from along the respiratory tract or digestive system. The respiratory tract includes the:

  • mouth
  • throat
  • nose
  • lungs
  • passageways leading to the lungs

Sometimes, blood-tinged sputum is a symptom of a serious medical condition. However, blood-tinged sputum is a relatively common occurrence, and typically isn’t cause for immediate concern. If you’re coughing up blood with little or no sputum, you should seek immediate medical attention.

Causes

Common causes of blood-tinged sputum include:

  • prolonged, severe coughing
  • bronchitis
  • nosebleeds
  • laryngitis
  • other chest infections

More serious causes of blood-tinged sputum, which require medical treatment, can include:

  • lung cancer or throat cancer
  • pneumonia
  • pulmonary embolism, or a blood clot in the lung
  • pulmonary edema, or having fluid in the lungs
  • pulmonary aspiration, or breathing foreign material into the lung
  • cystic fibrosis
  • certain infections, such as tuberculosis
  • taking anticoagulants, which thin blood to prevent it from clotting
  • trauma to the respiratory system

Lower respiratory infections or inhaling a foreign object are the likely causes of blood-tinged sputum in children.

When to see a doctor

You should call your doctor right away if you experience any of these symptoms.

  • coughing up mostly blood, with very little sputum
  • shortness of breath or struggling to breathe
  • weakness
  • dizziness
  • sweating
  • rapid heart rate
  • unexplained weight loss
  • fatigue
  • chest pain
  • you also have blood in your urine or stool

These symptoms are associated with serious medical conditions.

Diagnosis

When you see your doctor to diagnose the reason behind the blood-tinged sputum, they’ll first ask you if there was any noticeable cause such as:

  • a cough
  • a fever
  • the flu
  • bronchitis

They will also ask how long you’ve had blood-tinged sputum. They will ask how the sputum looks, how many times you cough it up in the day, and the amount of blood in the phlegm.

Your doctor will listen to your lungs while you breathe, and may look for other symptoms of concern, like a rapid heart rate, wheezing, or crackles. They’ll also ask you about your medical history.

Your doctor may also run one or more of these imaging studies or procedures to diagnose you:

  • They can use chest X-rays to diagnose a variety of different conditions. This is often one of the first imaging studies they’ll order.
  • They can order a chest CT scans to provide a clearer image of soft tissues for doctors to evaluate.
  • During a bronchoscopy, your doctor will look into your airways to check for obstructions or abnormalities by lowering a bronchoscope down the back of the throat and into the bronchi.
  • They can order blood tests to diagnose different conditions, as well as determine how thin your blood is.
  • If your doctor notices a structural abnormality in your lung, they may order a biopsy. They’ll remove a sample of tissue from your lungs and send it to a lab for evaluation.

Treatments

Treating blood-tinged sputum will rely on treating the underlying condition causing it. In some cases, treatment can also involve reducing inflammation or other related symptoms you’re experiencing.

Treatments for blood-tinged sputum can include:

  • oral antibiotics for infections like bacterial pneumonia
  • antivirals, such as Tamiflu, to reduce the length or severity of a virus
  • cough suppressants for a prolonged cough
  • drinking more water, which can help flush out remaining phlegm
  • surgery to treat a tumor or blood clot

For people who are coughing up massive amounts of blood, treatment first focuses on stopping the bleeding, preventing aspiration, which occurs when foreign material gets into your lungs, and then treating the underlying cause.

Call your doctor before using any cough suppressants, even if you know the underlying cause of your symptoms. Cough suppressants can lead to airway obstructions or keep the sputum trapped in your lungs, prolonging or worsening an infection.

Prevention

Blood-tinged sputum can sometimes be a symptom of an underlying condition that’s unavoidable, but methods are available to help prevent some cases of it. The first line of prevention is to prevent the respiratory infections most likely to cause it.

You can do the following to prevent blood-tinged sputum:

  • Stop smoking if you smoke. Smoking causes irritation and inflammation, and also increases the likelihood of serious medical conditions.
  • If you feel a respiratory infection coming on, drink more water. Drinking water can thin out phlegm and help flush it out.
  • Keep your house clean because dust is easy to breathe in, and it can contribute to or cause respiratory infections. Mold and mildew can also cause respiratory infections and irritation, which can lead to blood-tinged sputum.
  • Coughing up yellow and green phlegm may be a sign of a respiratory infection. Seeing your doctor for treatment early on to help prevent complications or a worsening of symptoms later.

Content licensed from:

Written by: Ana Gotter
Medically reviewed on: May 19, 2016: University of Illinois-Chicago, College of Medicine

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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