Bloody sputum: what to know

Sputum is mucus produced in the airways and brought up by coughing. A small streak can follow forceful coughing or irritation, but acute bronchitis and pneumonia may also cause blood-stained mucus. Bronchiectasis and COPD can make the airways more prone to bleeding, particularly during a flare or infection. Chronic sinusitis may drain blood-tinged mucus into the throat instead. These conditions can present with bloody sputum; seeing blood does not tell you which condition is present.

Keep the mucus visible in a tissue and note its amount, colour, and texture. Record fever, wheezing, breathlessness, chest pain, and how long the cough has lasted. Rest, drink fluids, and avoid smoke and vaping. Arrange medical assessment for unexplained recurrence or a cough that is not settling. Antibiotic treatment should follow a clinician’s diagnosis because it does not treat every cause of bloody sputum.

Call emergency services for heavy bleeding, severe difficulty breathing, chest pain, fainting, confusion, or blue or grey lips. Seek same-day advice if blood recurs, you have fever with worsening cough, or you have known lung disease. If the blood may be from the nose or throat, mention that detail during assessment so the clinician can check the correct areas.

What is the likely source of the blood? Do my cough and breathing need a chest examination or imaging? Could sinus drainage be contributing? What changes should prompt emergency care?