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Got blood in cough. No pain in neck or throat. What is the reason?

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General & Family Physician
Practicing since : 1973
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Since last 3-4 days whenever my sister coughs in the morning there is bright red blood in the cough. This happens only in the morning in the first cough.

She has no pain/sore in tongue or mouth . No pain in neck or throat also. What investigations should we do.
Posted Wed, 29 May 2013 in Lung and Chest disorders
Answered by Dr. S. Jegadeesan 2 hours later

Thanks for your query regarding your sister,

Your sister is having blood in the early morning cough (Hemoptysis). No major medical illness from the childhood, no pain or sore on the tongue and no pain in the neck or throat.

Bright red blood denotes that the blood should come from:
1) Sore anywhere in the mouth including the throat
2) Teeth
3) Respiratory tract including Lungs.
4) The NOSE is an important place to be examined by an ENT Doctor.

Mostly an inflammation in respiratory tract and bronchial tree is the cause.

One possibility is generalized bleeding tendency.

Another probable source is Lung.

We have to investigate for all possible causes:

A blood test like: Complete Hemogram, ESR, Montoux Test - This will reveal any bleeding tendency (Prothrombin time).

If indicated CT para nasal Sinuses and CT thorax.

If Montoux is positive then we may do sputum for Acid Fast Bacillus (AFB) + Sputum Culture and Sensitivity, Plain X-Ray Chest PA view will reveal any tuberculous infection in the bronchial tree.
Symptoms of tuberculosis are:
1) Evening rise of temperature.
2) Loss of appetite
3) Slow loss of weight
4) Frequency of respiratory infection

With the History + Symptoms + Investigations we can come to a conclusion and treatment is as per the diagnosis.

I wish her to recover from bleeding at the earliest

Best wishes

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