Yellow Sputum : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 27/07/2022

Yellow sputum is formed in the pathology of the bronchopulmonary system: acute and chronic purulent bronchitis, chronic obstructive pulmonary disease, lung abscess and bronchiectasis. Rare causes of the symptom include pulmonary eosinophilia, foreign bodies in the respiratory tract, oncological and congenital diseases. The diagnostic plan includes radiography and CT of the chest, bronchoscopy, spirometry, peak flowmetry. From laboratory methods, sputum examination, clinical and biochemical blood tests are used. Treatment is mainly medical - antibiotics, expectorants, bronchodilators and hormones. Operations are carried out if necessary.

Causes of yellow sputum

Purulent bronchitis

The acute process is characterized by frequent wet cough, which is accompanied by expectoration of dirty yellow sputum. Bronchial discharge is liquid, with an unpleasant odor, occasionally separate yellow-green lumps are found in it. Coughing increases in the morning, after inhalation. Patients experience pain in the chest, shortness of breath, fever.

In chronic bronchitis, outside the period of exacerbation, a person occasionally expectorates yellow sputum, but mostly the cough ends with the discharge of cloudy mucus. An increase in coughing 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, broncho-obstructive syndrome develops.

lung abscess

Isolation of yellow fetid sputum is characteristic of the second period of the disease - an abscess breakthrough into the draining bronchus. This happens suddenly: a dry cough is replaced by a wet one, then a large amount of liquid purulent discharge is expectorated with a “full mouth”. Taking into account the size of the infected cavity, up to 0.5-1 liters of yellow sputum can be released per day after opening the abscess.

There is a clear connection between the onset of coughing up yellow pus and the general condition of the patient. In the first period, the person suffers from hectic fever, chills, severe chest pains, and an agonizing, unproductive cough. After the discharge of sputum, the state of health quickly improves, body temperature returns to normal, signs of intoxication disappear.


The appearance of thick yellow sputum is typical for mild and moderate forms of pathology, while in severe cases, green discharge with a putrid odor is observed. Coughing up yellow pus occurs during an exacerbation of bronchiectasis (1-4 times per year). During the day, a person allocates up to 20 ml of yellow sputum, the main volume of which falls in the morning - after waking up, pus is coughed up with a “full mouth”.

During the day there are bouts of coughing with the accumulation of secretions in the bronchi. During paroxysms, a small amount of yellow sputum mixed with mucus is secreted. When the bronchial capillaries are injured due to a strong cough attack, streaks of blood are noticeable in the purulent discharge. The patient is worried about shortness of breath and symptoms of respiratory failure, intoxication, exhaustion of the body.

Yellow sputum


Chronic obstructive pulmonary disease

Isolation of yellowish sputum when coughing indicates an exacerbation of the disease and the addition of a bacterial infection. Patients complain of increased cough paroxysms during the day, after which thick sputum is expectorated. Specific changes in the bronchopulmonary system and ventilation disorders contribute to the multiplication of microorganisms, so 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) sputum, which is due to an increased content of eosinophils in the mucus. The symptom occurs in diseases of various etiology: parasitic pulmonary invasions (ascariasis, hookworm, strongyloidiasis), aspergillosis, acute and chronic eosinophilic pneumonia. Occasionally, yellow sputum is discharged during an attack of atopic bronchial asthma.

Kartagener syndrome

A congenital anomaly in the structure of the epithelium of the respiratory tract manifests itself in children from the first months of life. Ciliary dyskinesia leads to recurrent bacterial infections accompanied by purulent yellow discharge. At first, sputum is coughed up only during periods of exacerbation. After 2-3 years of age, the process becomes chronic, so scanty yellow discharge when coughing becomes a common symptom.

Foreign body of the bronchi

Expectoration of yellow sputum is possible with a long stay of a foreign object in the airways, 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 remissions, when sputum ceases to be expectorated.

Lungs' cancer

The appearance of yellow purulent secretions is typical of cancerous pneumonia, a serious complication of malignant neoplasia, which is caused by hypoventilation or atelectasis of a portion of the lung tissue. In addition to chest pain and intoxication syndrome, a person's temperature rises to febrile numbers, and there is a frequent wet cough with yellow sputum. A similar clinical picture is observed with pulmonary metastases.


In the presence of yellow sputum, the patient needs the help of a general practitioner or pulmonologist. During a physical examination of the patient, attention is paid to the participation of the chest in breathing, retraction of the intercostal spaces, and local areas of pain on palpation. Auscultation of the lungs provides valuable information - by the presence of wheezing, hard or amphoric breathing, a preliminary diagnosis is made. The diagnostic scheme includes the following methods:

  • X-ray studies. On the survey radiography of the chest in two projections, one can see areas of infiltration in the lungs, a rounded shadow with a horizontal fluid level, and local induration. To diagnose tumors, a CT scan of the chest is performed. Bronchography is performed to confirm chronic bronchitis.
  • Endoscopy of the bronchial tree. Bronchoscopy with visual inspection of large and medium-sized bronchi is an informative method for diagnosing chronic inflammatory and fibrotic processes and detecting malignant tumors. During the study, biopsy specimens of suspicious tissue are taken for examination under a microscope.
  • functional methods. In chronically occurring diseases of the bronchopulmonary system, external respiration is disturbed. To detect pathology, spirometry is prescribed, with the help of which the forced expiratory volume, vital capacity, and other indicators are assessed. For an express study, peak flowmetry is shown.
  • Sputum analyses. The cytological method is aimed at identifying eosinophils and neutrophils, specific crystals and spirals of mucin in the tracheobronchial secret. Bakposev with an antibiogram is used to determine the type of bacterial pathogen that caused the disease.

Additional diagnostic methods include a hemogram, which determines leukocytosis with an increase in ESR, eosinophilia, lymphopenia, as well as a biochemical blood test, which determines acute phase indicators, the ratio of plasma proteins. In chronic bronchopulmonary processes, the work of the heart is often disrupted, therefore, ECG and EchoCG are included in the examination plan.

Sputum analysis



Help before diagnosis

Coughing up yellow sputum indicates serious damage to the respiratory system, so a visit to the doctor should not be postponed. To alleviate the symptoms, you should ensure the unhindered discharge of pus. To do this, it is recommended to take special drainage positions, to massage the chest. 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 sputum is purulent, so patients need etiotropic antibiotic therapy. Drugs are selected empirically immediately after the diagnosis of the disease, and after receiving the results of the antibiogram, the treatment plan is adjusted. Against the background of the destruction of pathogenic bacteria, purulent sputum ceases to stand out. For pathogenetic and symptomatic treatment use:

  • Expectorants . Strengthen the discharge of thick sputum and thin it, accelerate the sanitation of the bronchial tree. Thanks to the intake of mucolytics and secretory drugs, recovery is faster.
  • Corticosteroids . Hormone therapy is justified in eosinophilic lung disease. The drugs quickly stop the inflammatory reaction, reduce the effects of allergies. Glucocorticosteroids are used in the form of aerosols or parenterally.
  • Bronchodilators . Isolation of yellow sputum in bronchiectasis or COPD requires the appointment of beta-agonists, anticholinergics. They are administered using nebulizers or spacers to ensure targeted delivery of the drug to the bronchi.


In case of bronchiectasis and other chronic pathologies, when conservative measures are ineffective, they resort to therapeutic bronchoscopy and sanitation of the bronchial tree. After washing and removal of pus, the condition of the patients improves. In case of complications of lung diseases with pleurisy, a puncture is performed to remove exudate, targeted administration of drugs.

Large abscesses, localized bronchiectasis, areas of suppuration in the complicated course of Kartagener's syndrome are subject to surgical removal. With the timely diagnosis of lung cancer, a radical operation is performed in combination with radiation or chemotherapy. To alleviate the condition of cancer patients at stages 3-4, palliative interventions are indicated.

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