Ask a doctor on the topic of Otorhinolaryngology

Blood traces in coughing - further questions

June 3, 2013 | 15,00 EUR | answered by Christian Welsch

Hello,

I had already asked here yesterday about blood traces in my cough. Background: 26, smoker and after a tonsillitis that turned into a cold (acute for 1 week, lingering for 1 week) I noticed slight blood traces when coughing on Saturday. The 3 days before that I had pain in my throat (not in my throat), which was probably the lymph nodes. These blood traces occasionally reappear, even though the majority of the phlegm is white and normal.

On Saturday evening, while brushing my teeth, toothpaste sprayed into my throat and I had a stronger coughing fit, after which my throat burned and I naturally had (slightly stronger) blood traces in the phlegm again. It felt as if some wound had opened. As a result, I went to the general practitioner as soon as possible today, who immediately sent me to the local specialist clinic for a thoracic X-ray (front and side) due to smoking + blood traces. Nothing was found, my lungs are healthy. The X-ray must have been done by a specialist as I was in the pulmonary practice. After that, I was sent to the ENT doctor who examined my larynx and could not find anything. The explanation is that there was a viral infection that is now subsiding. If the blood has not disappeared within a week, a bronchoscopy will be performed (under anesthesia).

The blood traces are similar to the small (needle-point sized) amounts and pieces that can occur during intense sneezing / nose blowing. Almost like tiny little veins falling out. I wouldn't even call it drops.

Have all the more serious or life-threatening diagnoses been ruled out by the previous examinations? Unfortunately, all the doctors were a bit monosyllabic, only the tumor was ruled out as a "worse" option. Is the viral infection really to blame? My father (bronchitis, chronic) said he has had it more often and for several years now, and one really shouldn't worry about it, various friends say the same.

But still, one worries, especially when not much was said in one's own case.

The last answer to the question was very reassuring, but I would like a second opinion from an ENT specialist.

Christian Welsch

Dear inquirer,

I can only agree with the assessment of my colleagues, this is certainly nothing serious. A bronchoscopy makes sense if a small vessel is suspected to repeatedly open in the bronchi. Smoking destroys the cilia on the respiratory mucous membranes, leading to an inability to clear the mucus produced by the mucous membranes in case of an infection, which can also be accompanied by blood clots.

Doctors calculate the risk of cancer in pack years; if you smoke a pack a day for a year, you have one pack year, if you smoke half a pack a day for a year, you need to smoke for 2 years to have the risk of one pack year. The risk of cancer increases exponentially from the 20th pack year onwards.

In my opinion, serious issues are ruled out; further diagnostics would only serve to rule out exotic causes, such as small vessel malformations in the lungs.

If you took aspirin during the infection, that alone could explain the bleeding. Aspirin can cause a tendency to bleed for up to 14 days, sometimes hidden in combination cold remedies.

Do not worry and perhaps take this incident as an opportunity to quit smoking.

If you have any questions,

Regards, C.Welsch