Green-colored sputum with a cough

Green sputum when coughing indicates an inflammatory process in the bronchi, trachea or lungs with the formation of mucopurulent or purulent exudate.

With intense inflammation, exudate accumulates and enters the secretions of the mucous membranes of the respiratory tract affected by the infection.

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Causes of green sputum when coughing

The main reasons for the appearance of green sputum when coughing are directly related to those diseases whose symptom is productive (wet) cough. Such diseases are tracheobronchitis, acute bronchitis and exacerbation of chronic bronchitis, pneumonia, bronchopneumonia, bronchiectasis, postpneumonic purulent pleurisy (pleural empyema), and lung abscess.

As experts note, if green sputum is released when coughing, it means that gram-positive and gram-negative bacteria such as Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Klebsiella spp., Serratia marcescens, etc. are involved in the occurrence of these diseases.

Bronchotracheitis of infectious etiology develops from tracheitis against the background of a fairly high temperature, rhinitis, pharyngitis or laryngitis, when the inflammatory process descends from the upper respiratory tract to the lower. If at the beginning of the disease the cough is dry, with attacks in the morning, then approximately on the 4-5th day the cough becomes productive, and yellow-green sputum appears when coughing.

Acute bronchitis, as well as exacerbations of its chronic form, is characterized by a strong cough, in which the patient coughs up mucopurulent exudate of a viscous consistency, yellow or greenish in color.

Among the clinical signs of bronchiectasis, which occurs as a result of damage to the walls of the bronchi and their expansion, green sputum is observed when coughing, often with bloody inclusions and particles of dead epithelial tissue of the bronchi.

In most cases of pneumonia, the bacterium Streptococcus pneumoniae, which doctors call pneumococcus, is to blame. However, pneumonia can also be caused by viruses (mainly the RS virus), fungal infections (pneumomycosis, which develops due to fungi of the genus Candida, Actinomyces, Histoplasma, etc.), and even parasites (pneumocystis pneumonia). But coughing up greenish sputum can occur with any etiology of pneumonia.

And in particularly severe forms of pneumonia, a pyogenic capsule may form in their tissues - a cavity with purulent-necrotic contents. In this case, a lung abscess is diagnosed, which eventually breaks through into the bronchi, and then when coughing, green sputum with pus comes out, which has a pronounced putrid odor.

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Diagnosis of green sputum when coughing

The exact cause of respiratory diseases accompanied by a cough with green sputum is determined by diagnostics. Unfortunately, the presence of green sputum during a cough is not always subject to a comprehensive study using proven diagnostic methods. This leads to the fact that when prescribing antibiotics, the causative agent of the inflammatory process is not taken into account, which means that with the same symptom, antibacterial drugs may not work and not lead to a cure for the disease or significantly slow down recovery and cause complications.

To determine the true origin of the cough, a more thorough examination is necessary based on:

• general blood test;
• biochemical blood test;
• blood test for eosinophils, mycoplasma, etc.;
• sputum culture for microflora;
• sputum smear bacterioscopy;
• general urine analysis;
• urine analysis for antigens;
• coprological examination (stool analysis);
• chest x-ray;
• spirometric study of respiratory parameters;
• bronchoscopy;
• Ultrasound or CT scan of the chest.

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Treatment for green phlegm when coughing

Currently, in clinical practice, the etiological treatment of green sputum during coughing, or rather diseases that have this symptom, is carried out with the help of antibiotics.

Prescribed for taking Ampicillin (synonyms - Ampexin, Domipen, Opicilin, Pentrexil, Riomycin, Cimexillin, etc.): adults - 500 mg 4 times a day; the daily dosage for children is calculated at 100 mg per kilogram of body weight and is divided into 6 doses within 24 hours.

Amoxicillin (synonyms - Augmentin, Flemoxin) adults and children over 10 years old take 0.5 g after meals - three times a day, children 5-10 years old - 0.25 g, children 2-5 years old - 0.125 g three times a day. The minimum course of treatment is 5 days.

In the treatment of green sputum when coughing in adults (with pneumonia), an effective third-generation fluoroquinolone antibiotic Levofloxacin (Levofloxacin, Tavanic, Tigeron, Flexid, etc.) in tablets can be used: before meals twice a day, 0.25-0.5 g; duration of administration is 5 days.

A five-day course of treatment for streptococcal respiratory tract infections with the antibiotic Rovamycin (in tablets of 1.5 and 3 million IU) is practiced. Adults should take 3 million IU three times a day, for children the daily dose is calculated per kilogram of body weight - 150 thousand IU per day - and is divided into three doses. Azithromycin (Sumamed) and Erythromycin are also used. And Josamycin (Vilprafen) is especially effective for inflammation of the respiratory tract caused by Peptococcus spp. or Peptostreptococcus spp. Doctors recommend taking the drug 500 mg three times a day.

In case of pneumonia of fungal etiology, treatment of green sputum during cough should be carried out with antifungal antibiotics, for example, Amphoglucamine. The recommended use of this is from 10 to 14 days: for adults - 200-500 thousand units twice a day (after meals); for children - depending on age (25-200 thousand units 2 times a day).

In drug therapy for viral bronchitis and pneumonia, antibiotics should be supplemented with antiviral agents (Remantadine, Acyclovir, Virazol, etc.), which the doctor prescribes individually - depending on the specific pathogen.

Treatment of green phlegm when coughing: means for liquefying and expectorating phlegm

The key principle that all doctors adhere to when prescribing symptomatic treatment for green sputum when coughing is to never suppress the cough reflex, but to promote the coughing up of accumulated exudate.

Expectorants act by expanding the bronchioles, which facilitates the removal of sputum. Terpin hydrate tablets (0.25 and 0.5 g) are prescribed one tablet three times a day. Mucaltin (based on marshmallow) should be taken before meals at 0.05-0.1 g 2-3 times (before meals). Lycorine hydrochloride - 0.1-0.2 mg 3-4 times a day (approximately 30-45 minutes before meals). Ammonia-anise drops should be taken for coughs in the following dosage: adults - 10-15 drops 2-3 times a day; children - at the rate of one drop for each year of life. Finally, Pertussin, which contains thyme extract and potassium bromide, stimulates the physiological activity of the ciliated epithelium and the peristalsis of the bronchioles, due to which any sputum, including green sputum, moves from the lower respiratory tract to the upper, and from there is removed. Adults should take Pertussin one tablespoon three times a day, children - one teaspoon or dessert spoon 2-3 times.

Mucolytic drugs make sputum less viscous, which makes it much easier to remove from the respiratory tract. Bromhexine (Bronchostop, Solvin), recommended by doctors, is used by adults and children over 14 years old at 8-16 mg 3-4 times a day; children 6-14 years old - 8 mg three times a day, 2-6 years old - 4 mg, children under 2 years old - 2 mg 3 times a day. The course of treatment is 5 days.

Ambroxol (other trade names are Ambroxol, Lazolvan, Bronchopront, Mucosan, Mucovent, Mucobroxol, etc.) increases mucus production in the respiratory tract. Adults are prescribed one tablet 2-3 times a day (after meals) or 10 ml of the drug in the form of syrup - three times a day. For children over 6-12 years old, the recommended dose of syrup is 5 ml (2-3 times a day); children aged 2-5 years - 2.5 ml; under 2 years - 2.5 ml twice during the day.

Acetylcysteine (Acestin, ACC, Muconex and other trade names) is prescribed to adults and children over 14 years of age at 200 mg 3 times a day; children 6-14 years old - 200 mg twice a day; children 2-5 years old are recommended to take the drug in the form of ACC effervescent tablets - 100 mg 2 times a day.

You can also use herbal infusions from the pharmacy for coughs with green sputum, which include licorice or marshmallow root, coltsfoot and oregano, black elder flowers, plantain leaves, and anise seeds. The medicinal decoction is easy to prepare: pour a tablespoon of the mixture with 250 ml of boiling water (or two tablespoons per half a liter of water) and leave it under a lid in a water bath for a quarter of an hour; then cool the decoction, strain it, and take half a glass twice a day (after meals).

Prevention of green sputum when coughing consists of effective treatment of coughing in any pathologies of the respiratory tract, without bringing it to the state of stagnation of sputum in the bronchi and lungs. The faster you get rid of sputum, the more favorable the prognosis for green sputum when coughing will be. Thus, acute bronchitis can be overcome in ten days, but chronic bronchitis will have to be fought much longer - one and a half to two months, or even more.

Remember that inflammation in the respiratory tract can lead to purulent bronchitis, chronic pneumonia, bronchiectasis, and lung abscess. In the latter case, pulmonologists say, serious problems arise that may require emergency surgery to resolve.

Therefore, you need to see a doctor if you have green phlegm when coughing.