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Streaks of blood in sputum. Advised neosprin for injury inside nose. Chest Xray,CBC normal. Sputum blood streaks again. Causes?

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Streaks of blood in sputum
For last 2 months my wife is noticing streaks of blood when she expels sputum, she initially ignored this problem, thinking this was due to small rapture in airways caused by forceful coughing, but when problem persisted for over two weeks even when cough was gone, then we consulted doctor, that point in time my wife was also feeling bit of dryness in her nose…
.. doctor detected small injury inside the nose due to dryness of nostrils … my wife was prescribed neosprin ointment for application inside nose, anti-allergy medicine and vitamin C tablets… she took this course of medicine for 10 days, and during this time she also consciously avoided expelling sputum…,this kind of resolved the problem, dryness of nose had gone , as she did not feel need to expel sputum therefore she did not see any blood steaks
That time we also did chest X-Ray and CBC differential, the reports were completely normal
However from last week onwards she started feeling pain in her throat, this pain was due to ulcer near left most corner at the root of tongue, with this, problem of blood streaks in sputum re-surfaced again (as she felt the need to expel sputum), doctor prescribed Betadine gargle, Montaire tablets and Vitamin C, ulcer is resolved in 4 days time, however she still see steaks of blood in sputum , from yesterday onward she again started feeling dryness in nose and small amount blood in nostrils .

Kindly give opinion on what could be the cause of blood streaks in sputum …is it due to allergy /dryness of nose/ulcer in throat or any other possible reason?
Posted Wed, 23 May 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for your query.

1. Get a videolaryngoscopy done. A common cause of blood streaked sputum and persistent cough is lymphoid hypertrophy in the throat. The delicate chronically inflamed lymphoid tissue usually harbors phlegm which drips down causing sudden bouts of cough, sometimes after eating or on change of position. This tissue is also sheared easily during coughing leading to the streaks of blood in the expectorated sputum.

2. Acid reflux may also be involved. It may be a contributing cause of the lymphoid hypertrophy, dryness in the throat and nose along with allergy.

3. Deficiency of Vitamin B12, C, D, calcium, hormonal imbalance (such as associated with PCOD) may also adding to this and must be corrected.

4. Anti allergic medication increases the dryness and must be used judiciously. A cough suppressant (as against an expectorant) will help. Anti-reflux medication with dietary changes will help.

I must emphasize that blood streaked sputum is usually not serious problem. It is usually investigated so as not to miss any rare cause. Kindly let me know the results of your investigations, with images and video of the videolaryngoscopy, if possible. This will help decide medication and further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Streaks of blood in sputum. Advised neosprin for injury inside nose. Chest Xray,CBC normal. Sputum blood streaks again. Causes? 58 minutes later
Many thanks Dr. XXXXXXX
Just one more clarification…
My wife does not have cough or any symptoms of seasonal cold , only during 1st week of March’12 (that when this problem began) she had throat congestion and associated cough symptoms , which got resolved within a week with Cronin Cold-n-flu , since then she did not experience any episodes of cough

Steaks of blood is seen whenever she expels mucus/sputum to clear her throat, not during or after cough, blood streaked sputum without cough could also be symptom of lymphoid hypertrophy ?

And one more question, what is the normal course of treatment for lymphoid hypertrophy and does it resolve itself or does it require any immediate medical intervention ?

Thank you
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

1. Blood streaked sputum without cough may also be a symptom of lymphoid hypertrophy or granular pharyngitis.

2. Treatment involves avoiding allergic foodstuff, antibiotics, anti-allergic medication, medicated gargles and sometimes a short course of steroids. Persistent, excessive lymphoid tissue may be cauterized, preferably by radio-frequency ablation or co-ablation.

Kindly let me know the results of your investigations, with images and video of the videolaryngoscopy, if possible. This will help decide medication and further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Streaks of blood in sputum. Advised neosprin for injury inside nose. Chest Xray,CBC normal. Sputum blood streaks again. Causes? 3 hours later
Thank you Dr. XXXXXXX

This is very helpful,
 
 
Answered by Dr. Sumit Bhatti 5 hours later
Hi,

Thank you for writing back.

Kindly let me know the results of your investigations, with images and video of the videolaryngoscopy, if possible. This will help decide whether lymphoid hypertrophy is the cause and plan further treatment. Other causes may co-exist as many medical problems tend to be multi-factorial in origin.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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