Patient's Query
Hello doctor,
I am a 33-year-old male. Yesterday, I started feeling body aches, headaches, and had a temperature of 37.8 degrees Celsius. Today, I feel slightly better; I have a mild headache. I just coughed up phlegm, and I do not know if it was a nasal drip or whether it was from my lungs, but there was blood in it.
Kindly advise.
Hello,
Welcome to icliniq.com.
I can understand your concern.
I have seen the picture (attachments removed to protect the patient's identity) of your sputum. Based on the history that you have provided, it looks like an upper respiratory tract infection. Sometimes, a small tinge of blood in the sputum is common with an upper respiratory tract infection. Just take treatment for an upper respiratory tract infection. It will resolve in the next four to five days, and you will be alright. If symptoms persist, then we shall evaluate further for lower respiratory tract infection or any other pathology. Another thing that I would like to know is whether you have any smoking or tobacco chewing history.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I smoked for five years till I was 23 years old. After that, I have not smoked for 10 years. I also had testicular cancer when I was 23, and I underwent chemotherapy.
Kindly help.
Hello,
Welcome back to icliniq.com.
Glad to have you back.
Your previous history of testicular cancer, which had been treated with chemotherapy, is significant because treated testicular cancer can present with recurrence in the abdomen and metastasis to the lung. I do not mean to say that you are having all this but symptoms with the previous history of testicular cancer cannot be ignored. I suggest you do a contrast-enhanced computed tomography (CECT) of the chest and abdomen, and check for some blood tumor markers like
I wish you good health.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
The treatment for testicular cancer was taken by me 10 years back, and I do not even consult my oncologist anymore. The last time I saw my oncologist was five years back and he declared that I was cured completely. I did a chest X-ray last year and that was unremarkable.
Thank you.
Hello,
Welcome back to icliniq.com.
Still, I suggest you do at least NCCT (non-contrast computed tomography) of the thorax along with the above-mentioned tumor markers.
Thank you.
Patient's Query
Hello doctor,
Do you suspect it could be lung cancer? I have only coughed up blood twice, and it is not a common recurrence.
Kindly help.
Hello,
Welcome back to icliniq.com.
According to me, considering your age and smoking history, along with your previous history, it looks like recurrence is more than lung cancer. But still, my first probable diagnosis is just a common cold or upper respiratory tract infection. But considering your previous history, we have to rule out lung metastasis from testicular cancer.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I have a feeling that if I go and visit my GP in the clinic, he will not give me a referral for a chest X-ray.
Kindly help.
Hello,
Welcome back to icliniq.com.
Glad to have you back.
So basically, a general physician will think in one way and an oncologist will think differently. You meet your general physician and tell them that an oncologist had asked you to do an NCCT thorax and check a few tumor markers. Most probably, it could be just an upper respiratory tract infection, but with the background of testicular cancer, we have to rule out other things.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I am so scared since it has happened twice again. I will make an appointment with my GP. My chest and back hurt when I breathe, but I think that could be muscular pain.
Kindly help.
Hello,
Welcome back to icliniq.com.
Do not be scared. Mostly it could be due to upper respiratory tract infection, but we have to rule out other things also.
Hope for the best.
Thank you.
Patient's Query
Hello doctor,
It is not like I have the need to cough or that I am coughing uncontrollably. I can feel the phlegm right at the bottom of my throat or in the chest area, and I cough it up forcefully to check whether there is blood, because I want to reassure myself that it is not there. Does this make sense?
I saw my GP, who has 37 years of experience. He said that three things could cause blood in phlegm. These are lung tumors, tuberculosis, or a chest infection. He did an oxygen test, and the oxygen level was 99 percent. He said that this alone would practically eliminate a lung tumor. He listened to my chest, and that also seemed to be normal. He said that there was nothing to worry about and that if it continues for another four days, I need to make an appointment with him again to get a chest X-ray done and a camera has to be inserted down my throat, but he advised that it would not be required.
I would like to mention that I am not coughing up blood, and I apologize if I was not clear in my initial post. It is as if it is the drip from the back of my throat. There is no accompanying persistent cough.
Hello,
Welcome back to icliniq.com.
I will get back to you shortly.
Thank you.
Patient's Query
Hello doctor,
I shall wait for your reply.
Thank you.
Hello,
Welcome back to icliniq.com.
I am really sorry for the late reply. Your physician is right, and I have also mentioned that most probably it would be nothing, but we have to rule out certain things, as you have a history of testicular cancer. So, as of now, it looks like an upper respiratory tract infection, and you can cough up the sputum, as it will not harm you.
If it does not resolve, then an NCCT thorax should be taken because we cannot get a clear picture from a chest X-ray regarding any kind of lung metastasis or lung tumor. Bronchoscopy (video camera through trachea) is also required if blood with sputum persists.
I hope it helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
A lot of people do not cough it out though. By that I mean I do not have a cough that is persistent. I just force it out from my throat.
Kindly help.
Hello,
Welcome back to icliniq.com.
If sputum comes, then you have to cough it out.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
But what if I swallow it? Please let me know.
Kindly help.
Hello,
Welcome back to icliniq.com.
Nothing will happen if you swallow it, but if it does not come out of your respiratory tract, it can cause a lung infection.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
I heard that it could be absorbed by the stomach. Is it true? Please let me know.
Kindly help.
Hello,
Welcome back to icliniq.com.
Whether it gets absorbed or not does make a major difference. The only thing is that if it is sputum-positive TB (tuberculosis), then it can also cause intestinal tuberculosis. Rest all is fine.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
But in your medical opinion, does everything that I have discussed not sound serious? Though I have a persistent cough, it subsides.
Kindly help.
Hello,
Welcome back to icliniq.com.
If the cough subsides, then it is fine, otherwise follow the above instructions.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
The cough has subsided, and I do not have a cough. It is just that when I grunt forcefully within my throat, I spit out phlegm, which has blood in it.
Kindly help.
Hello,
Welcome back to icliniq.com.
Good to hear that. Then, you need not do anything.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
So, is everything fine with me?
Kindly help.
Hello,
Welcome back to icliniq.com.
Yes, you are fine.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Even if the blood is present, is it not worrisome without a cough?
Kindly help.
Hello,
Welcome back to icliniq.com.
Glad to have you back.
If it is persistent, then please get evaluated by doing the above-mentioned investigation. If it subsides in the next two to three days, then it is fine.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
The result of the chest X-ray states that everything is clear.
Kindly help.
Hello,
Welcome back to icliniq.com.
Good to hear that. Now, you need not do anything, and you can be relaxed.
I hope this helps.
Thank you.
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