Q. What should I do if I spot blood in my phlegm?

Answered by
Dr. Anjali
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 23, 2022

Hello doctor,

I am a 20-year-old male with a height of 182 cm and weight 75 kilograms. I had a cold, cough, and fever a few days back. My doctor prescribed me antibiotics and Paracetamol for the same. I am almost recovered now, but the cough and phlegm are still present. The phlegm is often normal, but occasionally, when the phlegm is thick, I can clearly see blood in the yellow phlegm. Kindly give me advice on the same.

Thank you.



Welcome to

As per your history, you have a cough with expectoration (phlegm), and it is bloodstained. I would like to know a few things before I can suggest you on any treatment. Please answer the following questions:

1. Do you have any history of fever, loss of appetite, or weight change?

2. What is the duration of your cough?

3. Any history of smoking?

4. Any history of tuberculosis personally or in the family?

5. Any history of gum swelling or pain in teeth?

6. Is the blood in sputum throughout the day, or is it once in a while?

For further diagnosis, I would advise you to get the following investigations done:

1.Sputum test for acid-fast bacillus.

2. Sputum for gram stain and culture.

3. Sputum for CBNAAT (cartridge-based nucleic acid amplification test).

4. Chest X-Ray PA (posterior-anterior) view.

Please provide me with reports.

Thank you.

Hello doctor,

Thank you so much for your help.

Here are the answers you requested. I have never smoked. I have only recently developed a cough after fever, almost two to three days ago. No change in weight or appetite. No pain in my teeth. My grandmother had tuberculosis. The blood in the phlegm is once a day occurrence. Around a year ago, I spotted blood in my phlegm; although it was small in amount but was still present. When I cough thick or hard phlegm, some amount of blood is seen now. For the reports you requested, I have my exams from tomorrow, and so currently, it is not possible for me to get the tests done. Can you please tell me if this is serious?

Thank you.



Welcome back to

If it is once in a while occurrence, you can focus on your exams. But, after exams, I suggest you get the tests done for a better evaluation of the cause of blood in your sputum. In my professional opinion, you will need blood, sputum, and radiological investigations to identify the cause.

I suggest you take tablet Azithromycin 500 mg once a day for five days if you are not allergic to it. Then promptly get the investigations done after your exams.

I hope this helps. Feel better soon.

Thank you.

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