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Blood in the sputum when you cough.

, medical expert
Last reviewed: 04.07.2025
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Hemoptysis, which is expressed by the appearance of blood streaks in the mucus coming out during coughing, indicates that it indicates quite serious disorders associated with the perforation of some anatomical structures. Therefore, blood in sputum during coughing is an impetus for a mandatory visit to a specialist. Ignoring this signal, you can bring your health to more destructive, sometimes irreversible consequences.

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Causes of blood in sputum when coughing

Any deviation from the norm is a signal for a person to take a closer look at their body. Blood in sputum when coughing, from a medical perspective, is the release of any, even minimal, amount of both light arterial and dark venous blood. The color shade of the blood already gives a hint to a qualified doctor in which direction to look for the source of pathology. The reasons for the appearance of blood in sputum when coughing can be quite diverse:

  • The release of red blood cells from the lungs or bronchi can be provoked by damage to small blood vessels due to a sharp increase in blood pressure, which can occur at the moment of straining while coughing.
  • Blood in sputum when coughing can also occur with bronchiectasis. About 60-70% of such symptoms are provoked by these diseases.
  • A dark burgundy shade may indicate tuberculosis. For a fairly long time, a patient with this pathology in his/her anamnesis may have small amounts of foamy sputum, speckled with blood. Attacks usually intensify in the morning. Associated symptoms are usually increased activity of sweat glands, a general decrease in the tone of the entire body and a feeling of chills.
  • A similar picture with coughing is also obtained as a result of an oncological disease affecting the respiratory organs. For a long time, this disease does not manifest itself in any way and can be detected only by chance during a routine preventive examination, or in connection with the examination of another pathology. Over time, minor coughing fits begin to appear, which over time become more intense. After a while, clots and streaks of blood begin to appear in the secreted sputum. The patient's condition gradually worsens, especially in the morning. Sometimes it is very difficult to cough up, which does not give appetite and leads to weight loss of the patient. An unpleasant burning sensation occurs in the chest area.
  • The cause of blood in sputum when coughing can be acute pneumonia, as well as abscesses in the lung tissue. Symptoms of these pathologies can be brown sputum (a sign of the presence of a purulent process) with fresh, bright red streaks, as well as a "coughing" pain in the chest, high body temperature, general weakness. This whole complex of symptoms indicates the presence of an inflammatory process in the pulmonary system. Due to the suppression of the patient's defenses, another, more severe, complication can begin to develop against the background of inflammation - a lung abscess. At this stage of the disease, the cavities of the lung tissue, previously involved in the respiratory process, begin to fill with thick and viscous sputum, as well as pus. At the abscess stage, a sharp increase in the patient's body temperature is observed (the numbers on the thermometer can reach 40 ° C and above). Chest pain intensifies. During attacks, pus and brown-greenish sputum, weighed down by an unpleasant putrid odor, are released. The amount of blood inclusions increases. At night, mucus and pus stagnate in the bronchi and lungs, so in the morning, after sleep, the patient needs to cough well, get rid of stagnant products. The cough is very strong, "turning inside out", but after the sputum is released, temporary relief occurs, and the thermometer readings may decrease.
  • A sudden sharp pain in the chest area may indicate internal pulmonary bleeding. Breathing problems, blood in the sputum when coughing, which appears in large volumes. If such symptoms occur, urgent hospitalization of the injured person is necessary.
  • Bronchitis can also provoke hemoptysis. In acute or chronic forms of the disease, the patient suffers from fairly frequent and intense spasmodic attacks, causing pain symptoms, the release of large volumes of viscous mucus, sometimes with streaks of blood. Predominantly, the cough intensifies in the morning.
  • Minor bleeding can also be caused by some ENT diseases: tonsillitis, laryngitis, tracheitis.
  • In the process of decompensation of cardiovascular pathologies, pulmonary hypertension develops and begins to progress in the sick person. The patient faces the problem of lack of air in the lungs, there is a desire to take a deeper breath, shortness of breath appears, congestion in the lungs and blood in the sputum when coughing are observed.
  • Bleeding can be provoked by blockage of the pulmonary artery lumen. Such a manifestation can be a consequence of surgical intervention, and patients suffering from venous disease are also susceptible to this pathology. This picture of the disease in medical circles is designated by the term pulmonary embolism. Associated symptoms, in addition to blood discharge, include shortness of breath and severe acute pain behind the breastbone.
  • Hemoptysis can also be caused by other diseases, such as pulmonary echinococcosis (a helminthiasis from the group of cestodiasis, characterized by the formation of parasitic cysts in the liver, lungs or other organs and tissues), hemorrhagic purpura (small-spotted capillary hemorrhages into the skin, under the skin or into the mucous membranes).
  • Such pathological disorders as pulmonary vasculitis (respiratory dysfunction) and idiopathic pulmonary hemosiderosis (repeated hemorrhage into the alveoli with a wave-like recurrent course) can also provoke similar symptoms.
  • The appearance of blood in sputum when coughing may be caused by trauma or a rib fracture.
  • The appearance of bloody discharge may also be a consequence of such a hereditary pathology as respiratory cystic fibrosis, caused by disturbances in the normal functioning of the glands. Such a failure provokes prolonged and frequent inflammatory and cold diseases.
  • Blood can also differentiate during vomiting in the case of ulcerative manifestations, varicose veins or perforation of some organs of the digestive system: esophagus, duodenum, stomach. With one of these disorders, profuse bleeding with dark burgundy clots is observed.
  • A foreign object entering the respiratory tract can also provoke bleeding.

If such symptoms appear, you should immediately seek advice and help from a qualified specialist, and in case of intense bleeding, call an ambulance. Hemoptysis is serious and often very dangerous for human health. Delay in diagnosis and therapy, in some cases, can even cost the patient his life!

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Diagnosis of blood in sputum when coughing

Before proceeding to a comprehensive examination, based on the patient's complaints and visual examination, it is necessary to determine the location of the bleeding source - this will reduce the time it takes to make a correct diagnosis, and, therefore, will allow you to start therapy faster. The loss of even a small amount of time, in some cases, can cost the patient his life. But there are cases when it is very difficult to determine the location of the bleeding.

Diagnosis of blood in sputum during coughing is carried out using the following methods.

  • The first thing that is prescribed is laboratory testing of the sputum coming out. This analysis allows to confirm or refute diagnoses related to infection of the body with pathogenic microorganisms, for example, tuberculosis bacilli or staphylococci. It also shows the presence of an internal inflammatory process occurring in the body.
  • Clinical blood tests are mandatory. Based on the serum leukocyte count and the erythrocyte sedimentation rate (ESR), an experienced specialist can judge the nature of the inflammatory processes. Already at this stage, it is possible to narrow the diagnosis to pneumonia, pulmonary abscess, and an experienced pulmonologist can also say that this is bronchitis in the chronic or acute phase.
  • To diagnose cystic fibrosis (chlorine metabolism disorder), sweat gland secretions are analyzed. These changes are reflected in the chemical composition of sweat.
  • Bronchoscopy is also performed, allowing examination of the lumens in the bronchial ducts. An assessment is made of the condition of the duct walls, the uniformity of the diameter of the passage section (exclusion or confirmation of lumen blockage). This technique allows diagnosis of bronchiectatic diseases and lung cancer.
  • An informative method of examination when one of the diseases of the respiratory system is suspected is radiography (weaker - fluorography). With the help of X-rays, a picture is taken, on which, thanks to the darkening, it is possible to recognize pneumonia, the presence of a tumor, embolism or abscess.
  • Blood is tested for coagulability without fail; for this purpose, a coagulogram is performed.
  • One of the most informative methods today is computed tomography. This study provides a complete picture of the changes that have affected the area of interest to the doctor. With its help, abscess, malignant tumor, tuberculosis, bronchiectatic disease are diagnosed.
  • If there is a suspicion of a disturbance in the functioning of the heart, an electrocardiogram and echocardiography (an ultrasound examination method that allows one to obtain a picture of the functional and morphological disturbances in the heart muscles, anatomical structure and valvular apparatus of the heart) are prescribed.
  • If bleeding is suspected, the source of which is localized in the gastrointestinal tract, fibroesophagogastroduodenoscopy (FEGDS) is mandatory.
  • It wouldn't hurt to have a blood test for biochemistry.
  • Mantoux test.

Only after receiving a complete picture of the patient’s health condition, determining the location of the bleeding site and the disease that provokes it, can we talk about full-fledged treatment.

It is also possible to determine the disease by the color of the sputum coming out. But it should be taken into account that its color can also change due to the consumption of certain foods, such as red wine, blueberries, beet salad or coffee.

  • With pneumonia, the shade of discharge is usually from yellowish to greenish-yellow.
  • In the case of asthma, sputum, having high viscosity, is difficult to cough up and has a transparent appearance.
  • In case of progressive pulmonary edema, foamy discharge with blood streaks is observed.
  • Lobar pneumonia can be diagnosed by rusty-colored discharge.
  • With bronchitis and infectious flu, the discharge is purulent, greenish-yellow in color, often with blood streaks.
  • In cases of bronchiectasis and pulmonary abscess, sputum with a greenish tint can be observed.
  • Lung abscess is differentiated by brownish-yellow sputum.
  • A characteristic sign of the bronchogenic form of malignant tumor of the lung is discharge with blood fibers.
  • In case of pulmonary infarction, bright red discharge is observed.
  • If the lungs are affected by a fungus, one can observe white sputum coming out in flakes when coughing.

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Treatment of blood in sputum when coughing

Before starting treatment, it is necessary to determine the diagnosis. Otherwise, the wrong therapy can not only fail to help, but also worsen the situation, while precious time will be lost irretrievably. Treatment of blood in sputum when coughing is determined by the disease that causes it; treating the symptoms in this case makes no sense.

If tuberculosis is diagnosed, anti-tuberculosis therapy is prescribed. Combined forms are mainly used, which include several drugs that work together. The treatment process starts with the prescription of four different first-line drugs. This may be isoniazid, streptomycin, pyrazinamide, rifampicin or ethambutol.

Streptomycin is administered to the patient intramuscularly. Adult patients are prescribed a single dose of 0.5 to 1 g at a time. The patient may receive no more than 2 g of the drug per day. If the patient's body does not tolerate the drug well, or his body weight is less than 50 kg, or the patient is over 60 years old, the amount of the drug administered per day is 0.75 g, divided into two doses.

For small patients under three months of age, the daily dose of the drug is calculated as 10 mg per kilogram of the newborn's weight. For babies from three to six months, the daily dose of the drug is calculated as 15 mg per kilogram of the baby's weight. For children from six months to two years, the daily dose is 20 mg per kilogram of the child's weight. If the child is under 13 years old and for adolescents, the daily dose is from 15 to 20 mg per kilogram of the small patient's weight, but it should not exceed 0.5 g per day (for children under 13) and 1 g (for adolescents).

In case of tuberculosis, the medicine is administered to the patient once a day, if poorly tolerated, it is divided into two doses. The duration of the drug course is from three months and further. The duration of therapy is determined by the attending physician, based on the patient's health condition.

Streptomycin is contraindicated in case of individual intolerance to the drug and its components, severe chronic renal dysfunction, aggravated by uremia and azotemia, damage to the nerves of the cranial localization, as well as in case of pregnancy. It should be prescribed with special caution if the patient's medical history includes myasthenia, Parkinson's disease, bleeding tendency, cardiac dysfunction, botulism, cerebrovascular accident and some other pathologies.

If first-line drug therapy is ineffective or the patient has a high intolerance to first-line drugs, then the treatment is adjusted by discontinuing the first anti-tuberculosis drugs and prescribing second-line drugs. These include rifabutin, ethionamide, para-aminosalicylic acid, prothionamide, ofloxacin, kanamycin, cycloserine, thioacetazone, capreomycin, and ciprofloxacin.

The active substance ethionamide (aethionamidum) is prescribed for oral administration. For an adult patient, the average daily dosage is 500 to 1000 mg, divided into two or three doses, the amount of medication administered for small patients is calculated as 20 or 40 mg per kilogram of the patient's weight, divided into two doses (administered in the morning and before bedtime).

Ethionamide is not recommended for use if the patient has a history of severe liver dysfunction or if they are pregnant.

Treatment therapy for pneumonia and bronchitis cannot be done without antibiotics. Doctors include amoxicillin, ceftazidime, penicillin, cefoperazone and cefepime in the first line of drugs.

Amoxicillin (Amoxycillinum) is intended for oral administration. The quantitative component is selected strictly individually depending on the pathogen, the severity of the pathology, the viability of kidney function, the patient's age and body weight.

Patients over ten years of age and adults are prescribed 0.5 g three times a day; in severe cases of the disease, the dose of the administered drug can be increased, if necessary, to 1.0 g three times a day. Children under two years of age are prescribed the drug in the form of a suspension at the rate of 20 mg per kilogram of the child's body weight, divided into three doses (this corresponds to a quarter of a teaspoon). From two to five years of age - 0.125 g (which is equivalent to half a teaspoon), divided into three doses. From five to ten - 0.25 g (one teaspoon), divided into three doses.

The suspension is prepared independently, 100 ml of clean water, previously boiled and cooled to room temperature, is added to the dry preparation. Shake well before use.

The drug is contraindicated for use in cases of infectious mononucleosis, in cases of increased intolerance by the patient's body to the components of amoxicillin, as well as during pregnancy.

If the patient's body shows high intolerance to first-line drugs, an allergic reaction to the drug has occurred, or this therapy is ineffective, the attending physician changes tactics, replacing the first drugs with second-line drugs. These include: ticarcillin, ceftriaxone, cefotaxime, ciprofloxacin, and piperacillin.

Ciprofloxacin (Ciprofloxacinum) should be taken on an empty stomach. For easier administration, it is worth washing down with the required amount of liquid. For patients with a history of kidney failure, the dose of the recommended drug is halved.

The amount of medication required to achieve a therapeutic effect is selected individually for each patient, based on the severity of the disease, the patient's age and general health, the type of invasive microorganism, body weight and renal function.

In case of moderate lower respiratory tract disease, the medicine is administered to the patient in the amount of 0.25 g, divided into two doses. In case of severe course of the pathology, the dosage can be doubled and correspond to 0.5 g, twice during the day.

The duration of the course of therapy is controlled by the attending physician. After the disappearance of uncomfortable, dangerous symptoms, to consolidate the achieved result, the drug must be taken for two more days. Usually, the treatment course is on average from seven to ten days.

Contraindications to ciprofloxacin include glucose-6-phosphate dehydrogenase deficiency, viral keratitis, individual intolerance to one or more components of the drug, or patient age under 18 years.

If the attending physician diagnoses bronchiectasis or lung abscess, then surgical intervention is necessary. In case of cancer pathology, anticancer therapy is carried out using the necessary medications, and surgery may also be indicated.

There are also a number of other recommendations that are advisable to follow during the period when a person is bothered by a cough.

  1. It is necessary to drink plenty of fluids.
  2. Eliminate bad habits, especially smoking.
  3. Stabilize your diet by removing irritating foods (such as hot spices) from your diet.
  4. Productive sleep.
  5. Regular ventilation, wet cleaning of living and working areas.

In parallel with specific medications, expectorants, bronchodilators, enveloping, and anti-inflammatory drugs can be introduced into the treatment protocol.

In this situation, both medicinal forms produced on the basis of plant raw materials, as well as synthetic and semi-synthetic drugs, are suitable.

It is worth considering that patients with a history of damage to the central nervous system, for example, cannot be given thermopsis or ipecac. This can only worsen the situation, provoking attacks of severe coughing and vomiting. In small patients, these drugs can cause respiratory arrest, which leads to asphyxia and aspiration.

Mucoregulatory drugs promote better discharge of secretions, and many of them, in combination with antibiotics, allow the latter to penetrate the bronchial tree secretion more easily. Such drugs as carbocysteine, ambroxol, bromhexine or acetylcysteine are especially actively used today. They should not be used in case of bronchial asthma in a patient.

Carbocisteine is prescribed for oral administration to the patient. The starting dosage for an adult patient is 0.375 g, which corresponds to two capsules of the drug or one and a half tablespoons of the drug in syrup form - this is identical to three teaspoons (0.25 g / 5 ml). The drug is taken three times a day.

For children under five years of age – half a teaspoon of syrup (dosage 0.125 g/ 5 mg), administered into the body four times a day. For children between five and twelve years of age – one teaspoon (0.25 g/ 5 ml) or one tablespoon of syrup (0.125 g/ 5 mg), taken three times a day. If the expected effect is observed, it is advisable to reduce the dosage of the administered drug by half.

Contraindications to the administration of carbocysteine may include individual intolerance of the patient's body to the components of the drug, as well as an active peptic ulcer in his medical history, in the case of an acute phase of diseases such as cystitis and glomerulonephritis.

Expectorants are prescribed to reduce the viscosity of sputum, its volume increases, and it becomes easier to remove it. Such drugs include ammonium chloride, sodium bicarbonate, potassium iodide and sodium iodide.

Sodium bicarbonate is prescribed by the attending physician orally. The dosage of the drug corresponds to figures from 0.5 to 1.5 g. The amount of the drug taken depends on the pH level of the acidity of the gastric juice.

As an expectorant, sodium bicarbonate is used for washing the nasal passages, as a solution for rinsing the mouth and throat. It is also effective as an inhalation agent (solutions with a concentration of 0.5 to 2% are used). This chemical compound has virtually no contraindications for use, the only limitation for use may be poisoning with strong acids. In this case, sodium bicarbonate should not be taken internally.

Mucolytic drugs stabilize the process of utilization of bronchial secretion, making its exit more effective. Mainly used in pediatric therapy. For example, the drug ACC. Therapy of diseases such as tracheitis, bronchitis, pneumonia.

In case of blood in sputum when coughing, you should not rely on traditional medicine methods. It would not be superfluous to take natural immunostimulants. They will support the body in the "fight" against the disease and will not allow a secondary infection to develop, which can only worsen an already difficult situation.

Prevention of blood in sputum when coughing

As the proverb goes, "never say never". It is also impossible to completely insure yourself against the pathology in question, but it is quite possible to take measures to reduce the likelihood of the disease, the symptom of which is blood in sputum when coughing. Prevention of blood in sputum when coughing includes methods that allow you to keep the bar of your own body's immune defense at a high level.

  • You should remove bad habits from your life, especially nicotine.
  • Avoid contact with volatile chemicals that are highly toxic. If this is not possible, use a special protective suit and mask.
  • Minimize exposure to harsh X-rays and ultraviolet radiation.
  • Frequent ventilation of living and working spaces is necessary, at least four to six times a day.
  • You can quartz the room at least once a day.
  • Walks in the fresh air are also beneficial.
  • Balanced nutrition, the diet should include foods rich in vitamins and microelements. Eat more vegetables and fruits.
  • It would not be a bad idea to practice hardening procedures.
  • Adhere to the rules of personal hygiene.
  • Moderate physical activity.
  • Emotional stability. More positive emotions. Cheerful attitude.

Blood in sputum when coughing prognosis

It is quite difficult to give a clear prognosis for blood in sputum when coughing. Too many different diseases can cause such symptoms. And if, for example, we are talking about a violation of the integrity of small vessels due to high blood pressure, then it will be enough to monitor its parameters and the symptoms will go away on their own, the same can be said about pneumonia or bronchitis. Timely diagnosis and adequate complex treatment, and the prognosis for blood in sputum when coughing is quite favorable.

The situation is much more complicated if the cause of blood in sputum when coughing is lung cancer or a pathology comparable in severity to oncology. But even in this case, you should not give up. The earlier the diagnosis is made and the necessary therapeutic measures are taken, the higher the probability of a favorable outcome of treatment.

Cough is one of the many symptoms that our body uses to signal pathological changes affecting it. Blood in sputum when coughing is a more serious warning sign. But to sum up the above, we should conclude that if you or someone close to you has these symptoms, do not self-medicate under any circumstances - it can be simply life-threatening. For the same reasons, complex therapy is not prescribed until the pathology that caused hemoptysis is established. Only by establishing the correct diagnosis can you protect the patient's body from complications and prescribe a truly effective therapy. Be more attentive to yourself, your health and the health of your loved ones! After all, early diagnosis is the key to a quick recovery with minimal consequences!

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