Blood stain in sputum: what to know

Sputum is mucus brought up from the airways. A red mark may appear after inflammation, infection, or forceful clearing. Acute bronchitis and pneumonia can cause airway irritation; bronchiectasis and COPD can also produce blood-streaked sputum. Blood from the nose or throat may be mixed in before the mucus is spat out.

The amount, colour, duration, and accompanying symptoms help a clinician narrow the source. Fever, breathlessness, chest pain, a long-standing cough, and repeated episodes should all be reported. A blood stain does not by itself establish a diagnosis.

Arrange a clinical review if you cannot identify a simple mouth or nose source, or if the sputum changes or the blood returns. Keep a note of episodes and bring a list of medicines, including those that affect clotting. Avoid smoking and do not take antibiotics left over from another illness; antibiotic treatment is chosen only when appropriate.

Seek emergency help for ongoing or increasing bleeding, more than a small streak, difficulty breathing, chest pain, fainting, confusion, or blue-grey lips. Urgent review is warranted when blood accompanies fever and severe weakness, or when it keeps appearing. Tell the service if you take anticoagulant or antiplatelet medicine.

Ask whether the blood appears to be from the lungs or upper airway, whether you need imaging or a sputum sample, and how to monitor the symptom. Ask which changes should prompt emergency help and whether a medicine could be increasing bleeding.