Sputum
Colour
• Clear (mucoid): COPD/bronchiectasis without current
infection/rhinitis.
• Yellow (mucopurulent): acute lower respiratory tract
infection/asthma.
• Green (purulent): current infection – acute disease or
exacerbation of chronic disease, such as COPD.
• Red/brown (rusty): pneumococcal pneumonia (Fig. 5.3B).
Try to distinguish between rusty and frank red blood (see
below).
• Pink (serous/frothy): acute pulmonary oedema.
In bronchiectasis, the colour of sputum may be used to guide
the need for antibiotic treatment
Volume
• Establish the volume produced over 24 hours: small
amounts into a tissue or enough to fill a spoon(s),
eggcup(s) or cup(s).
• Compare the current volume with the patient’s baseline or
minimal volume.
Consistency
• An increase in stickiness (viscosity) may indicate
exacerbation in bronchiectasis.
• Large volumes of frothy secretions over weeks/months
are a feature of the uncommon bronchoalveolar cell
carcinoma.
• Occasionally, sputum is produced as firm ‘plugs’ by
patients with asthma (Fig. 5.3C), sometimes indicating
underlying allergic bronchopulmonary aspergillosis.
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