Mucopurulent Sputum : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 20/09/2022

Mucopurulent sputum is a symptom of common diseases of the respiratory system: tracheobronchitis, acute and chronic bronchitis, pneumonia. The symptom is often found in tuberculosis, chronic obstructive pulmonary disease, congenital anomalies in the development of the respiratory system. Rare causes of mucopurulent sputum: chronic lung abscesses, actinomycosis, malignant tumors. The diagnostic plan includes X-ray and endoscopic methods, the study of respiratory function, laboratory tests of sputum and blood. Treatment includes antibiotics, anti-tuberculosis drugs, expectorants, and bronchodilators.

Causes of mucopurulent sputum


Mucopurulent sputum is possible with any acute process in the respiratory system, but most often it occurs with acute bronchitis or tracheobronchitis. Yellowish-green purulent streaks in expectorant mucus are detected on the 2nd-3rd day of the disease. The patient is concerned about frequent wet cough, chest pain and fever. Sputum production lasts 1-2 weeks, after which the process gradually subsides, when coughing, a meager amount of mucus leaves.

Exacerbation of chronic bronchitis and simultaneous infection with pathogenic bacteria contribute to the discharge of mucopurulent sputum. Unlike an acute illness, the secret is mainly coughed up in the morning after a night's sleep or during special events - postural drainage, inhalation. The discharge from the bronchi is thick, with an unpleasant odor.


Moderate amounts of mucopurulent sputum are characteristic of focal pneumonia. The patient complains of chest pain on one side, which is aggravated by a cough attack. Paroxysms are accompanied by the release of yellow mucus with separate lumps of pus, which has an unpleasant odor. With lobar pneumonia, there is also mucopurulent sputum, but often there are blood streaks in it.


Sputum appears in the decay phase, for example, with fibrous-cavernous pulmonary tuberculosis. At the time of coughing, the patient secretes thick mucus interspersed with purulent impurities, which is difficult to expectorate and has a sharp unpleasant odor. There is a deterioration in well-being: body temperature rises, weakness and malaise increase, dull pain in the chest worries. Mucopurulent sputum is usually accompanied by hemoptysis.


Chronic obstructive pulmonary disease is characterized by the constant secretion of small amounts of mucopurulent sputum. More often, expectoration occurs in the morning after an intense coughing paroxysm, and during the day the symptom bothers much less often. Mucus with impurities of pus is secreted in the bronchitis variant of the disease. In addition, patients complain of edema, skin cyanosis, shortness of breath.

Mucopurulent sputum


Chronic lung abscess

The illness lasts for months or years. All this time, patients are periodically disturbed by a wet cough with mucus and pus. The sputum is viscous and turbid with a sharp offensive odor. In the period of exacerbation of an abscess, against the background of hypothermia or SARS, the amount of discharge increases to 300-50 ml per day. The mucopurulent nature of expectorant sputum is replaced by purulent, putrefactive or bloody.


Pathology has a primary chronic course. Wet cough with mucopurulent discharge occurs a couple of months after infection with a radiant fungus. With thoracic actinomycosis, expectoration of sputum with a taste of copper or iron, a specific smell of damp earth is pathognomonic. Symptoms periodically increase or disappear, and may persist for several years.

Congenital pathologies

Anomalies in the formation of the bronchopulmonary system cause hypoventilation and secretion stagnation, which contributes to the development of pathogenic microorganisms. The appearance of mucopurulent sputum is typical for lung hypoplasia, Kartagener's syndrome, bronchogenic cyst. The symptom occurs in those suffering from cystic fibrosis, which is complicated by a secondary bacterial infection.

Tumors of the lung

Cough with discharge of mucopurulent sputum occurs already at the beginning of the development of central lung cancer, while in the peripheral process the symptom is determined only with a massive lesion of the parenchyma. Clinical manifestations are not associated with infection, do not have clear provoking factors. Patients note prolonged (several months) expectoration of mucous sputum with purulent admixture, constant dull pain in the chest, causeless weight loss.


The examination is carried out by a therapist or pulmonologist. When collecting an anamnesis, a specialist is interested in the duration of the onset of symptoms, the presence of occupational hazards, and chronic diseases. Physical examinations of the respiratory system are performed. To establish the causes of the formation of mucopurulent sputum, the following are used:

  • Methods of non-invasive visualization. Standard radiography of the lungs shows infiltrative foci, areas of destruction of the parenchyma, space-occupying formations. To clarify the diagnosis, CT, MRI of the chest is prescribed. In order to identify pathological processes in the pleural cavity, ultrasound is recommended.
  • Invasive research. For a detailed examination of the condition of the bronchi, an endoscopic method is used - bronchoscopy. During the examination, the doctor may take tissue samples from pathologically altered areas. Bronchography with contrast helps to confirm developmental anomalies and deformation of the bronchi.
  • functional tests. Indicated for the study of violations of the function of external respiration caused by chronic processes. For express research, peak flowmetry is used. Spirometry with the determination of quantitative indicators of respiration and a test with salbutamol provides information for differential diagnosis.
  • Sputum studies. With a microscopic analysis of the secret, its consistency and physical characteristics are evaluated, pathological inclusions are found - spirals, mucous plugs. Sputum culture is carried out to detect a pathogenic pathogen and establish its sensitivity to antibacterial drugs.

Additionally, clinical and biochemical blood tests are carried out, changes in which reflect inflammatory processes in the body. Diagnosis of mycoses is carried out using serological reactions. To confirm tuberculosis, a Mantoux test is performed, a modern highly sensitive quantiferon test. If a hereditary pathology of the respiratory organs is suspected, the results of molecular genetic methods are indicative.

Sputum analysis



Help before diagnosis

Self-medication for diseases accompanied by mucopurulent sputum is fraught with complications, so the patient should consult a specialist. To reduce unpleasant symptoms, a warm alkaline drink, herbal medicinal preparations with an expectorant effect, and breathing exercises are recommended. Coughing up fetid sputum with a full mouth or the appearance of blood in the discharge is a reason for urgent medical attention.

Conservative therapy

Mucopurulent sputum is coughed up with a large number of diseases, so the treatment plan is selected according to the diagnosis. Regardless of the etiological factor, general measures are necessary: ​​a sparing motor regime, nutrition with a restriction of heavy, spicy, cold food. With a sharp deterioration in the patient's condition, hospitalization is indicated. The following medicines are used:

  • Etiotropic agents. In bacterial infections, antibiotics are used, taking into account the sensitivity of the identified pathogens. When infected with Koch's bacillus, 3-4 modern anti-tuberculosis drugs are taken for a long time. Treatment of fungal infections of the lungs includes antifungal medications.
  • pathogenic drugs. To speed up recovery, it is important to ensure a good discharge of sputum from the bronchial tree with the help of secretory drugs and mucolytics. The drugs thin the mucus and improve its expectoration. For the same purpose, inhaled bronchodilators are prescribed.

Physiotherapy plays an important role in treatment. Medicinal inhalations, electrophoresis with calcium chloride and potassium iodide on the anterior surface of the chest are effective. To improve the discharge of mucopurulent sputum, vibration massage and postural drainage are used. After the acute process subsides, UHF, speleotherapy, and exercise therapy are performed. With persistent remission of chronic pathologies, sanatorium treatment is recommended.


Minimally invasive therapy methods in the form of therapeutic bronchoscopy are prescribed to flush the bronchial tree and cleanse the airways from accumulated viscous sputum. With an extensive tuberculous process with decay, some malformations of the lungs, resection of the affected segments is used. In resectable lung cancer, radical surgery is performed in combination with radiation and chemotherapy techniques.

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