What should you know about blood specks in sputum?

Small red streaks may appear when inflamed airway lining is rubbed by coughing. Acute bronchitis can produce phlegm and a persistent cough, while pneumonia may bring fever, chest discomfort, or breathlessness. Bronchiectasis and COPD can also present with blood-streaked sputum. Blood from the nose, gums, throat, or stomach can sometimes be mistaken for sputum, so its colour, texture, and source matter. The symptom alone cannot identify the cause.

Note when the specks appeared, how often they occur, their colour, and whether they are mixed through the phlegm or only on its surface. Avoid smoking and stay hydrated unless a clinician has restricted your fluids. Arrange a medical review when the blood returns, the cough persists, or you also have fever, wheezing, chest pain, or reduced exercise tolerance. Do not start leftover antibiotics; treatment depends on the cause and antibiotics do not help every cough.

Seek emergency care for more than a trace of blood, ongoing bleeding, severe breathlessness, blue lips, fainting, confusion, sudden chest pain, or a rapid heartbeat. Urgent assessment is also appropriate if you take blood-thinning medicine, have a known lung condition, or feel acutely unwell. Keep any tissue or photograph available to show the clinician if the bleeding stops before assessment.

Could the blood be coming from my nose or throat rather than my lungs? Do I need a chest examination, sputum sample, or imaging? Which symptoms would mean I should return urgently? Is any medicine increasing bleeding risk?