Blood in sputum: symptoms to watch

Blood-streaked phlegm may occur when coughing irritates inflamed airways. Acute bronchitis, pneumonia, bronchiectasis and COPD can present with blood in sputum, while mucus draining from chronic sinusitis can be cleared from the throat. A small amount can also come from the nose, mouth or gums rather than the lungs. The symptom itself cannot tell you which cause is present.

Pay attention to fever, breathlessness, chest pain, wheezing, a persistent or worsening cough, tiredness, night sweats, weight change, or a change in the usual amount and colour of phlegm. Note whether the blood is streaked through mucus or appears separately, and whether it is recurring.

If blood returns or you have ongoing cough or phlegm, book a clinical review and bring a clear description of what you noticed. Rest, drink fluids and avoid smoking or vaping. Do not suppress important symptoms with leftover medicines or begin antibiotics on your own. A clinician may check your nose, throat, oxygen level and chest, then decide whether tests or targeted treatment are appropriate.

Seek emergency help if bleeding is more than a small streak, continues, or makes it hard to breathe. Chest pain, fainting, confusion, blue lips, severe weakness, or a high fever with rapid deterioration also require urgent attention. If you take medicine that affects clotting, contact a clinician promptly after noticing blood, even when the amount seems small.

Where is the blood most likely coming from? Which accompanying symptoms change the urgency? Should my regular medicines be reviewed? Do I need a chest examination or other tests, and what should I monitor at home?