Yellow phlegm is formed in the pathology of the bronchopulmonary system: acute and chronic purulent bronchitis, chronic obstructive pulmonary disease, lung abscess and bronchiectatic disease. Rare causes of the symptom include pulmonary eosinophilia, foreign bodies entering the respiratory tract, oncological and congenital diseases. The diagnostic plan includes radiography and CT of the chest organs, bronchoscopy, spirometry, peak flowmetry. From laboratory methods, phlegm examination, clinical and biochemical blood tests are used. Treatment is mainly medical – antibiotics, expectorants, bronchodilators and hormones. If necessary, operations are performed.
Causes of yellow phlegm
Purulent bronchitis
The acute process is characterized by a frequent wet cough, which is accompanied by expectoration of dirty yellow phlegm. The bronchial discharge is liquid, with an unpleasant odor, occasionally there are individual yellow-green lumps in it. Coughing increases in the morning, after inhalation. Patients experience chest pains, shortness of breath, and an increase in body temperature.
In chronic bronchitis, outside the period of exacerbation, a person occasionally expectorates yellow phlegm, but mostly the cough ends with the discharge of cloudy mucus. An increase in cough attacks and an increase in the amount of purulent discharge of yellow color is noted with an exacerbation of inflammation. The symptom is combined with signs of intoxication, decreased performance. With a long history of bronchitis, bronchoobstructive syndrome develops.
Lung abscess
The release of yellow fetid phlegm is characteristic of the second period of the disease — the breakthrough of the abscess into the draining bronchus. This happens suddenly: a dry cough is replaced by a wet one, then a large volume of liquid purulent secretions is expectorated with a “full mouth”. Taking into account the size of the infected cavity, up to 0.5-1 liters of yellow phlegm can be released a day after the opening of the abscess.
There is a clear connection between the beginning of coughing up yellow pus and the general condition of the patient. In the first period, a person suffers from hectic fever, chills, severe chest pains and a painful unproductive cough. After phlegm discharge, well-being improves rapidly, body temperature normalizes, signs of intoxication disappear.
Bronchiectatic disease
The appearance of thick yellow phlegm is typical for mild and moderate forms of pathology, whereas in severe cases, green discharge with a putrid odor is observed. Coughing up yellow pus occurs during the exacerbation of bronchiectatic disease (1-4 times a year). During the day, a person secretes up to 200 ml of yellow phlegm, the bulk of which falls in the morning — after waking up, pus is expectorated with a “full mouth”.
Throughout the day, coughing attacks occur with the accumulation of secretions in the bronchi. During paroxysms, a small amount of yellow phlegm mixed with mucus is released. When the bronchial capillaries are injured due to a severe coughing attack, blood veins are noticeable in the purulent discharge. The patient is concerned about shortness of breath and symptoms of respiratory failure, intoxication, exhaustion of the body.
Chronic obstructive pulmonary disease
The release of yellowish phlegm during coughing indicates an exacerbation of the disease and the addition of bacterial infection. Patients complain of increased coughing paroxysms during the day, after which thick phlegm is expectorated. Specific changes in the bronchopulmonary system and ventilation disorders contribute to the reproduction of microorganisms, therefore purulent processes in COPD are observed several times a year.
Pulmonary eosinophilia
The pathognomonic symptom of this group of pathologies is the appearance of bright yellow (canary) phlegm, which is caused by an increased content of eosinophils in mucus. The symptom occurs in various etiological diseases: parasitic pulmonary invasions (ascariasis, hookworm, strongyloidosis), aspergillosis, acute and chronic eosinophilic pneumonia. Occasionally, yellow phlegm departs with an attack of atopic bronchial asthma.
Cartagener syndrome
Congenital abnormality of the structure of the epithelium of the respiratory tract is manifested in children from the first months of life. Ciliary dyskinesia leads to recurrent bacterial infections accompanied by purulent yellow secretions. At first, phlegm clears up only during periods of exacerbation. After 2-3 years of age, the process is chronicled, so scanty yellow discharge when coughing becomes a familiar symptom.
A foreign body of the bronchi
Expectoration of yellow phlegm is possible with prolonged presence of a foreign object in the respiratory tract, which contributes to the development of purulent inflammation around it. The process is sluggish, so a meager amount of pus is released when coughing. The disease proceeds according to the type of chronic pneumonia with alternating periods of exacerbations and remission, when phlegm stops expectorating.
Lung cancer
The appearance of yellow purulent discharge is typical for cancerous pneumonia — a serious complication of malignant neoplasia, which is caused by hypoventilation or atelectasis of a section of lung tissue. In addition to chest pains and intoxication syndrome, a person’s temperature rises to febrile numbers, there is a frequent wet cough with yellow phlegm. A similar clinical picture is observed with pulmonary metastases.
Diagnostics
In the presence of yellow phlegm, the patient needs the help of a general practitioner or a pulmonologist. During the physical examination of the patient, attention is paid to the participation of the chest in breathing, the retraction of intercostal spaces, local areas of pain during palpation. Valuable information is provided by auscultation of the lungs — a preliminary diagnosis is made by the presence of wheezing, hard or amphoric breathing. The following methods are included in the diagnostic scheme:
- X-ray examinations. On the overview radiography of the chest organs in two projections, you can see areas of infiltration in the lungs, a rounded shadow with a horizontal fluid level, local compaction. A CT scan of the chest organs is performed to diagnose tumors. To confirm chronic bronchitis, bronchography is performed.
- Bronchial tree endoscopy. Bronchoscopy with visual examination of the bronchi of large and medium caliber is an informative method for the diagnosis of chronic inflammatory and fibrous processes, the detection of malignant tumors. During the study, biopsies of suspicious tissue sites are taken for examination under a microscope.
- Functional techniques. With chronically occurring diseases of the bronchopulmonary system, external respiration is disrupted. To detect pathology, spirometry is prescribed, with the help of which the volume of forced exhalation, vital capacity of the lungs, and other indicators are evaluated. Peak flowmetry is shown for the express study.
- Phlegm tests. The cytological method is aimed at identifying eosinophils and neutrophils, specific crystals and spirals of mucin in the tracheobronchial secretion. Bakposev with an antibioticogram is used to determine the type of bacterial pathogen that caused the disease.
Additional diagnostic methods include a hemogram, which determines leukocytosis with increased ESR, eosinophilia, lymphopenia, as well as a biochemical blood test, which determines acute phase parameters, the ratio of plasma proteins. With chronic bronchopulmonary processes, the work of the heart is often disrupted, therefore, ECG and EchoCG are included in the examination plan.
Treatment
Help before diagnosis
Coughing up yellow phlegm indicates a serious lesion of the respiratory system, so you can not postpone a visit to the doctor. To alleviate the symptoms, it is necessary to ensure the unhindered discharge of pus. To do this, it is recommended to take special drainage positions, do chest massage. It is forbidden to use antitussive drugs that contribute to the stagnation of pathological secretions in the bronchial tree.
Conservative therapy
In most cases, yellow phlegm has a purulent character, so patients need etiotropic antibacterial therapy. Medications are selected empirically immediately after the diagnosis of the disease, and after receiving the results of the antibioticogram, the therapy plan is adjusted. Against the background of the destruction of pathogenic bacteria, purulent phlegm ceases to stand out. For pathogenetic and symptomatic treatment, use:
- Expectorants. They enhance the discharge of thick phlegm and dilute it, accelerate the sanitation of the bronchial tree. Thanks to the use of mucolytics and secretomotor drugs, recovery is faster.
- Corticosteroids. Hormone therapy is justified for eosinophilic lung damage. The drugs quickly stop the inflammatory reaction, reduce the phenomena of allergies. Glucocorticosteroids are used in the form of aerosols or parenterally.
- Bronchodilators. The release of yellow phlegm in bronchiectasis or COPD requires the appointment of beta-adrenomimetics, cholinolytics. They are administered using nebulizers or spacers to ensure targeted delivery of the drug to the bronchi.
Surgical treatment
In bronchiectatic disease and other chronic pathologies, when conservative measures are ineffective, medical bronchoscopy and bronchial tree sanitation are resorted to. After washing and removal of pus, the condition of patients improves. In case of complication of lung diseases with pleurisy, a puncture is performed to remove exudate, targeted administration of medications.
Large abscesses, localized bronchiectasis, areas of suppuration with a complicated course of Cartagenera syndrome are subject to surgical removal. With timely diagnosis of lung cancer, radical surgery is performed in combination with radiation or chemotherapy. Palliative interventions are indicated to alleviate the condition of cancer patients at stage 3-4.
