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Forum Name: Chest symptoms

Question: Bloody sputum, maily in the morning


 Mr.Jak - Sun Sep 07, 2008 4:08 am

Hi. I am a 30 year old previous smoker. The last year I have stopped but with a few reoccurrences. Firstly about a year a go I started coughing up brown gunge after a bad chest infection, which I hope is all the tar from smoking, that prompted me to stop smoking. Then more recently, over the past couple of months, there has been blood in there as well. Not much to start with, just streaks, but then last week it seemed to be slightly more and almost in little wet lumps about 2mm across. I have had a chest Xray a year a go which was clear and have had a camera down my nose to check my larynx which again was clear. I have also been to the doctors a few times over the last 3 months worried as its not going away but my doctor doesn't seem as alarmed as I am as I'm not the right age to realistically have cancer.

I am currently half way through a course of Amoxycillin to clear up potential infection. Thing is, I cant workout whether its from my chest or sinuses, as its mainly in the morning (occaisionally I have had blood in the afternoon). When I blow my nose there is no blood but I think this morning when I cleared the back of my nose and spat it out there was blood. Can I request the doc to give me a CT scan or is it on their judgement?

Any advice would be greatly appreciated.
A concerned and very confused Mr.Jak
 John Kenyon, CNA - Mon Oct 20, 2008 10:16 pm

User avatar Hi Mr. Jak -

Well no one is happy to see blood in the sputum, and it does warrant some concern, especially in a former smoker, but while age isn't a really good measure of the likelihood of cancer, if there's no marked family history of it, this is more likely due to a chronic sinus infection, as you've guessed. Often blood and mucus can be aspirated from the sinuses down into the lungs during sleep. Coughing up whatever is down there will bring the blood-streaked mucus as well. This does not guarantee there is nothing serious going on, but cancer is less likely, and the fact that you were able to bring up bloody sputum from the back of your throat makes it seem more likely you have a chronic sinus infection that's producing the questionable sputum.

This should be evaluated by your doctor, as a matter of course, and you may need to be placed on an antibiotic if there is an infection. Whether or not your doctor feels a CT of the lungs is appropriate is entirely the doctor's call, although you certainly are free to make the suggestion and voice your concerns and how this might help ease your mind. It certainly would do no harm, but because it may be quite clear upon examination and listening to your lungs that you have no real issue down in there, the doctor could decline to order the CT.

Former smokers frequently are more prone to this sort of problem because cigarette smoke (and heated air) drawn into the lungs damages the cilia (the little, hair-like "helpers" in the bronchii that help move phlegm up and out), resulting in more aspirated drainage just sitting around, mostly in the bronchial tree, til it becomes thick enough to provoke a cough. Then it is thicker and if there is blood in the sinuses (which often happens), it shows up in the older, often colorful mucus.

I hope this eases your mind some, and that you'll at least bring up the CT idea to your doctor if he doesn't bring it up first. It can't hurt, although it may well not be necessary.

In the meantime, an over-the-counter expectorant (guaifenesen, brand-name Mucinex) can help loosen the stuff in your chest and make it easier to cough up, which may actually resolve the problem.

Best of luck to you and please keep us updated.
 bobbiep - Fri Apr 03, 2009 10:00 am

I had a very bad cold and horrible cough about 5 weeks ago which took me to the ER and after several blood tests and chest xray I was sent home to simply rest and recover. I continued to cough (productive) and finally stopped about 2 weeks later. I then started having pressure pain in my sinus above my eyes and on my cheekbones. I took extra vitamin C and used my neti pot to rinse the sinuses with warm saline water. I started being awaked at night by a terrible taste in my mouth and spitting out first tan colored sputum and then slighly bloody. This has continued so I went to my doctor who had labs done and everything was normal, chest xray was normal, so she is treating me for allerigies and post nasal drip. I have a humidafier in my bedroom at night, drink lots of water to thin the mucus and during the daytime I feel good. But at night the same thing is occuring and I am scared.

The doctor wanted me to take predisone for a week to reduce inflammation, but I would not take it as I read several articles that were negative so I want my doctor to swab my throat and see what the cutural will show and then take ciproflaxin as it is the only antibotic that does not give me severe side affects.

She offered to do a MRI of my chest to make me feel more calm about this, but is that appropriate, or should it be a MRI of the sinus cavaties. How can you tell where this bloody sputum is coming from, chest or sinus?

Your input will be sincerely appreciated. I need to stop obsessing over this as my husband has just started dialysis and that is enough of a problem for me emotionally without adding in any more.


Thank you very much.

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