Ask a doctor on the topic of Otorhinolaryngology

Traces of blood in cough

June 2, 2013 | 15,00 EUR | answered by Dr. med. Frauke Gehring

Hello,

I am 26 years old and have been smoking again for a year (previously smoke-free for 3 years). Last week, I started with a sore throat that developed into cold symptoms. Over the weekend, I was flat on my back, but on Monday I felt well enough to go to work. (although not completely well) The symptoms have been decreasing, except for occasional coughing and mucus in the morning.

Yesterday morning, there was blood in my phlegm, tiny spots and "threads" of very light blood, and definitely more mucus than blood. Shocked, I went to the emergency room at the hospital, where I was diagnosed with ICD 10 codes R04.2+Z and J04.2+V. The doctor said the blood was harmless. He listened to my lungs, but did not perform an x-ray or CT scan. This morning and last night, there were again small amounts of blood and very small red "pieces" (mostly one at a time). I am not sure if I should request further treatment, or if it is really normal and just that my mucous membranes are irritated, similar to blood in mucus during a severe cold. Of course, the fear of "cancer" is always in the back of my mind, and the fear is accordingly great.

The urge to cough is hardly present anymore, and when I cough up mucus, it is usually clear. The doctor said it could be a viral infection, but the blood is very concerning to me.

Dr. med. Frauke Gehring

Good evening,

Just the blood is an indication of a viral infection, as many viruses make the blood vessels porous, so that blood can be mixed with mucus. In bacterial infections, blood in the mucus is much rarer.

You can safely wait for one to two weeks. If you continue to feel better and no more blood appears, it is likely a viral infection and no further diagnostics are necessary. Only if there are persistent blood inclusions will an X-ray need to be taken, or later a bronchoscopy.

I do not think of cancer in this case, because you are simply too young and have too few years of smoking behind you, but rather of a stubborn infection or a benign polyp.

Nevertheless, it would be good to take this as an opportunity to quit smoking for good. In 10 to 20 years, you would have every reason to worry if you continue to smoke...

I wish you all the best!

Sincerely, Dr. Höllering, Specialist in Internal and General Medicine