Cough mixed with blood

Blood mixed with phlegm should be assessed, because causes range from irritated airways to conditions needing urgent treatment. Even a small streak should be discussed with a clinician if it is new, recurrent, or unexplained.

A forceful cough can irritate the throat or small airway blood vessels. Blood may also occur with acute bronchitis, bronchiectasis, asthma-related irritation, or another chest infection. Blood from the nose or gums can mix with saliva and appear during coughing. Bright red blood, clots, increasing amounts, breathlessness, chest pain, fever, or dizziness make the situation more urgent. The appearance alone cannot establish the cause.

Contact a healthcare professional and describe the colour, approximate amount, number of episodes, and whether it was mixed with mucus. Mention smoking or vaping, recent infection, nosebleeds, chest symptoms, and medicines that affect clotting. Do not ignore repeated episodes or rely on cough syrup to mask them. Keep any prescribed medicines available, but do not stop a regular medicine that affects clotting unless a clinician tells you to.

Call emergency services if you are coughing up a large or increasing amount of blood, struggling to breathe, have severe chest pain, feel faint or confused, or develop blue or grey lips. Seek urgent assessment for recurrent blood, fever with worsening illness, unexplained weight loss, or a cough that continues. A clinician may examine your nose, throat, and chest and arrange tests based on the findings.

Could the blood be from my nose, throat, or lungs? Does my medicine affect bleeding? Which symptoms mean I should go to emergency care? What examination or test is appropriate if this happens again?