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Sputum green when coughing

, medical expert
Last reviewed: 17.10.2021
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Green sputum when coughing speaks of an inflammatory process in the bronchi, trachea or lungs with the formation of mucopurulent or purulent exudate.

With intense inflammation, the exudate accumulates and enters the secretions of the mucous membranes of the respiratory tract affected by the infection.

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Causes of green sputum on coughing

The main causes of the appearance of green sputum when coughing are directly related to those diseases, the symptom of which is a productive (wet) cough. Such diseases are tracheobronchitis, acute bronchitis and exacerbation of chronic bronchitis, pneumonia, bronchopneumonia, bronchiectatic disease, post-pneumonia purulent pleurisy (empyema of the pleura), as well as lung abscess.

As specialists note, if green sputum departs from the cough, then such gram-positive and gram-negative bacteria as Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Klebsiella spp., Serratia marcescens and other

Bronchotracheitis infectious etiology develops from the tracheitis amid a sufficiently high temperature, rhinitis, pharyngitis or laryngitis, when the inflammatory process descends from the upper respiratory tract to the lower ones. If the cough is dry at the beginning of the disease, with bouts in the mornings, then on the 4th-5th day the cough becomes productive, and yellow-green sputum appears on coughing.

For acute bronchitis, as well as exacerbation of its chronic form is characterized by a strong cough, in which the patient coughs up the mucopurulent exudate of a viscous consistency of yellow or greenish color.

Among the clinical signs of bronchiectasis arising from damage to the walls of the bronchi and their expansion, there is a green sputum when coughing, often with bleeding inclusions and particles of dead epithelial tissues of the bronchi.

In most cases of pneumonia (pneumonia), the bacterium Streptococcus pneumoniae, which doctors call pneumococcus, is to blame. However, pneumonia can also be caused by viruses (mainly RS virus) and fungal infection (pneumomycosis that develops due to fungi of the genus Candida, Actinomyces, Histoplasma, etc.), and even parasites (pneumocystis pneumonia). But a cough of a greenish color can be with any etiology of pneumonia.

And with especially severe forms of pneumonia in their tissues, a pyogenic capsule can be formed - a cavity with purulent-necrotic contents. In this case, an abscess of the lung is diagnosed, which eventually breaks through to the bronchi, and then a green sputum with pus, which has a pronounced putrefactive smell, leaves behind the cough.

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Diagnosis of green sputum when coughing

The exact cause of diseases of the respiratory system, which are accompanied by a cough with green sputum, is designed to establish diagnostics. Unfortunately, the presence of green sputum when coughing is not always subjected to a comprehensive study with the use of proven diagnostic techniques. This leads to the fact that when the antibiotics are prescribed, the pathogen of the inflammatory process is not taken into account, and therefore, with the same symptom antibacterial drugs may not work and do not lead to a cure of the disease or slow the recovery and cause complications.

To find out the true origin of cough, a more thorough examination is needed on the basis of:

  • a general blood test;
  • biochemical blood analysis;
  • a blood test for eosinophils, mycoplasma, etc .;
  • sowing sputum on the microflora;
  • sputum smear microscopy;
  • general analysis of urine;
  • analysis of urine for antigens;
  • koprologicheskogo research (analysis of feces);
  • chest x-ray;
  • spirometric study of respiratory rates;
  • bronchoscopy;
  • Ultrasound or CT of the chest.

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Treatment of green sputum when coughing

Currently, in the clinical practice, the etiologic treatment of green sputum when coughing, or rather, diseases that have this symptom, is carried out with the help of antibiotics.

Appointment Ampicillin (synonyms - Ampexin, Domipen, Opicilin, Pentrexyl, Riomycin, Cimexillin, etc.): adults - 500 mg 4 times a day; The daily dosage for children is calculated at 100 mg per kilogram of body weight and is divided into 6 doses in 24 hours.

Amoxicillin (synonyms - Augmentin, Flemoxin) adults and children older than 10 years take after eating 0.5 g - three times a day, children 5-10 years - 0.25 g, children 2-5 years - 0.125 g three times per day. The minimum course of treatment is 5 days.

In the treatment of green sputum during coughing in adults (with pneumonia), an effective third generation fluoroquinolone antibiotic Levofloxacin (Levoflocin, Tavanic, Tigeron, Flexid, etc.) can be used in tablets: before meals, twice daily, 0.25-0.5 g; duration of admission is 5 days.

Practiced a five-day course of treatment of streptococcal infections of the respiratory tract with antibiotic Rovamycin (in tablets of 1.5 and 3 million IU). Adults should take it to 3 million IU three times during the day, children a daily dose is calculated per kilogram of body weight - 150 thousand IU per day - and is divided into three doses. Also used are Azithromycin (Sumamed) and Erythromycin. And Josamycin (Vilprafen) is especially effective in the inflammation of the respiratory tract, triggered by Peptococcus spp. Or Peptostreptococcus spp. Doctors recommend taking the drug 500 mg three times a day.

With pneumonia of fungal etiology, treatment of green sputum with cough should be performed with antifungal antibiotics, for example, Amphoglucamine. The recommended use of this is 10 to 14 days: adults - 200-500 thousand units twice daily (after meals); children - depending on the age (25-200 thousand units, 2 times a day).

With drug therapy of viral bronchitis and pneumonia, antibiotics should be supplemented with antiviral agents (Remantadine, Acyclovir, Virazol, etc.), which the doctor appoints individually - depending on the specific pathogen.

Treatment of green sputum during cough: means for liquefaction and coughing up phlegm

The key principle that all physicians adhere to when prescribing the symptomatic treatment of green sputum when coughing is not to suppress the cough reflex, but to help cough up the accumulated exudate.

Expectorants act by dilating the bronchioles, which facilitates the excretion of phlegm. Tablets Terpinhydrate (0.25 and 0.5 g) are prescribed one tablet three times a day. Mukaltin (based on the drug althea) should be taken before meals at 0.05-0.1 g intake 2-3 times (before meals). Lycorina hydrochloride - 0.1-0.2 mg 3-4 times a day (approximately 30-45 minutes before meals). Narrow-anis drops should be taken with a cough in this dosage: adults - 10-15 drops 2-3 times a day; children - at the rate of one drop for each year of life. Finally, Pertussin, containing in its composition thyme extract and potassium bromide, stimulates the physiological activity of the ciliated epithelium and peristalsis of bronchioles, due to which any, including green sputum when coughing, moves from the lower parts of the respiratory tract to the upper ones, and from there it is withdrawn outward. Adults should take Perthussin on a tablespoon three times a day, children - on a tea or dessert spoon 2-3 times.

Mucolytic drugs make sputum less viscous, which greatly facilitates its removal from the respiratory tract. Recommended medics Bromhexine (Bronchostop, Solvin) is used by adults and children over 14 years of age to 8-16 mg 3-4 times a day; children 6-14 years - 8 mg three times a day, 2-6 years - 4 mg, children under 2 years - 2 mg 3 times a day. The course of treatment is 5 days.

Ambrohexal (other trade names - Ambroxol, Lazolvan, Bronhopron, Mukozan, Mukovent, Mucobroxol, etc.) increases the production of mucus in the respiratory tract. Adults drug is given one tablet 2-3 times a day (after a meal) or 10 ml of the drug in the form of a syrup - three times a day. Children older than 6-12 years, the recommended dose of syrup is 5 ml (2-3 times a day); children aged 2-5 years - 2.5 ml each; up to 2 years - 2.5 ml twice a day.

Acetylcysteine (Acestin, ATSTS, Mukoneks and other trade names) for adults and children over 14 years of age appoint 200 mg 3 times a day; children 6-14 years - 200 mg twice a day; for children 2 to 5 years, the drug is recommended in the form of effervescent tablets ATSTS - 100 mg 2 times a day.

Pharmaceutical plant collections including licorice or althaea root, mother-stepmother's and oregano grass, blackberry flowers, large plantain leaves, anise seeds can also be used for coughing with green sputum. Preparing the medicinal broth is simple: a tablespoon of the mixture is poured 250 ml of boiling water (or two tablespoons per half-liter of water) and infused under a lid in a water bath for a quarter of an hour; then the broth should be cooled, drain and take half a cup twice a day (after eating).

Prevention of green sputum during coughing consists in the effective treatment of cough in any pathology of the respiratory tract, without bringing it to the state of sputum stagnation in the bronchi and lungs. The faster you get rid of phlegm, the more favorable will be the forecast of green sputum when coughing. So, acute bronchitis can be overcome in ten days, but with chronic it will have to be fought much longer - one and a half to two months, or even more.

Remember that inflammation in the airways can lead to purulent bronchitis, chronic pneumonia, bronchiectasis, lung abscess. In the latter case, according to pulmonologists, serious problems arise, for the solution of which you may need urgent surgical intervention.

Therefore, you should consult a doctor if you have a green sputum when you cough.

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