Identify phlegm by its color, and identify diseases by phlegm! 11 colors and 3 properties, master them quickly!

Sputum is familiar to the public. Different diseases correspond to different colors and shapes of sputum. Sometimes, the patient's condition can be roughly judged by observing the sputum without pathological or biochemical examinations. After checking relevant information, the editor has summarized 11 colors and 3 properties of sputum to help clinicians quickly "identify sputum by color and distinguish diseases by sputum."

1. White

1. Under normal circumstances

The sputum of healthy people is a small amount of thin white sputum, while long-term smokers have relatively more sputum.

2. Inflammation

For example, patients with upper respiratory tract inflammation and acute bronchitis cough up white sputum. It should be noted that if the white sputum has stringy texture, it means fungal infection has occurred.

2. Pink

Pink foamy sputum is usually considered a typical manifestation of acute pulmonary edema. Patients may also experience irritability, sweating, severe dyspnea and violent coughing, and even orthopnea.

3. Brick Red

The patient had brick-red jelly-like sputum, which was considered to be Klebsiella pneumonia, and multiple honeycomb-like lung pus appeared.

4. Rust color

If rust-colored sputum appears, and there was an upper respiratory tract infection, cold, rain, and high fever, shortness of breath, chills, chest tightness, chest pain, etc. before the onset of the disease, most people will directly consider it to be pneumococcal pneumonia, also known as lobar pneumonia. (Rust-colored sputum often appears 24 to 48 hours after onset.)

5. Green

1. When the sputum appears green, it may be considered a respiratory tract infection caused by Pseudomonas aeruginosa. At this time, most patients have symptoms such as fever and chills.

2. Green mucus flows back into the throat and is discharged, which may be mistaken for coughing up green sputum. At this time, atrophic rhinitis may be considered.

6. Yellow

1. If the patient has yellow sputum during a cold, and the sputum color gradually darkens and can be coughed up, it is considered that the patient has entered the recovery period of the cold.

2. If the patient has yellow sputum, it may be due to a lower respiratory tract infection, such as acute and chronic bronchitis, bronchiectasis, suppurative pulmonary inflammation, tuberculosis, etc.

3. If a large amount of yellow purulent sputum is present, accompanied by fever, fatigue, poor appetite and other symptoms, it may be considered that the patient has a non-purulent infection, or has bronchiectasis, pulmonary tuberculosis cavities, etc.

7. Reddish brown/chocolate

If reddish-brown or chocolate-colored sputum appears, it is generally considered to be pulmonary amoebiasis, which is caused by amoebic liver abscess spreading to the lungs.

8. Brown

If brown sputum appears and is accompanied by symptoms such as hemoptysis, wheezing, chest pain, and fever, the patient is considered to be in the acute stage of allergic bronchopulmonary aspergillosis.

9. Lemon

Regarding lemon-colored sputum, it is more common in patients with simple pulmonary eosinophilia, often accompanied by symptoms such as fatigue, headache, chest pain, and night sweats.

10. Blood sample

When a patient has bloody sputum, it is considered that Legionella infection has occurred. At this time, the patient will have symptoms such as profuse sweating, fever, chest pain, and fatigue.

11. Black/Gray

Generally speaking, black or gray sputum is often considered to be various pneumoconiosis (such as coal ash, charcoal dust, stone powder, iron dust, etc.), which is more common in people who smoke too much or healthy people who live in an environment rich in ash.

In addition to identifying sputum by color, if the sputum is found to be in the following state, it can also be used to promptly identify the disease:

1. Blood in sputum

1. For patients with a long history of smoking and chronic lung disease, blood in sputum may mean that there is a lesion somewhere in the body, which requires timely examination and identification.

2. Blood in sputum can be caused by lung infection, lung abscess, tuberculosis, lung cancer and other diseases. For lung cancer, blood in sputum when coughing up sputum is one of the typical early symptoms of lung cancer.

2. Thin serous sputum containing powdery substances

When the patient has a large amount of thin serous sputum containing powdery substances, it is considered to be echinococcosis caused by infection with the larvae of Echinococcus tapeworm, such as hepatic echinococcosis, pulmonary echinococcosis, and cerebral echinococcosis.

3. Layered Purulence

If there is a large amount of purulent sputum and it is layered (the upper layer is foam, the middle layer is purulent sputum, and the lower layer is necrotic tissue sediment), bronchiectasis is considered.

In summary, although sputum is a common symptom, sometimes the state and color of sputum have a certain reference value for judging the disease and the severity of the condition. Of course, the determination of sputum color is subjective, and in clinical practice, it is still necessary to combine relevant laboratory tests to accurately determine the disease and condition.

References

[1] Chen Li. Identifying diseases based on the color of sputum[J]. Medical World, 2020, 3(5):1-3.

[2] Lin Guowei, Wang Jiyao, Ge Junbo. Practical Internal Medicine[M]. 15th edition. Beijing: People's Medical Publishing House, 2017: 1204-1213.

[3] Hu Pinjin, Xie Canmao. Differential diagnosis of internal medicine diseases[M]. 6th edition. Beijing: People's Medical Publishing House, 2014: 93-100.

Text丨Fu Yujie

Proofread by Feng Xiwen

Edited and reviewed by Huang Shan