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What Causes Coughing Up Of Green Mucus In The Morning?

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Posted on Tue, 4 Nov 2014
Question: Hello,

I received my blood test results this week (I attached the blood results).

My Lymphocyte Count is low 17.3 & Neutrophils count is high 77.1

All other blood results appear to be normal.

I've been sick for the past two months with sever nasal inflammation, nose pressure soreness/pain (feels cold all the time), chronic mucus draining (morning especially bad with green/yellow mucus), NO NIGHT SWEATS. I also discovered two very bad infected teeth in my upper jaw that I just had removed over the past two weeks. I feel warm all over but I am not running a fever (I haven't ran a fever in the past two months as I check it almost every day). When I first wake up in the morning my body feels really tired and I feel even more sick. Its' like my body is trying to fight off something. I feel sickish most ever day like there is something just not right. I had the final infected tooth removed this past Tuesday. This particular tooth was going into my sinus cavity but the CT Scan showed no infection in my sinus cavity but that side of my face was sore and my nose on that side has been really sore.

Let me provide provide you a timeline of when this started and where I am today:

========================================

Aug 9th: I started to get a sore throat

Aug 10th: I work up with a fever, sore throat, coughing up green/yellow mucus, really bad nose and sinus, glands in neck felt swollen, I felt chills so I probably had a fever. This all last for about 3 days.

Aug 13th: my sore throat went away glands did not appear swollen but my nose and sinus felt really sore with a lot of pressure mostly on my right side and I was still coughing up green/yellow mucus in the morning

Aug 20th: I went to the doc who prescribed me Augmentum (for 10 days)

Aug 20th - Sept 2nd: I took the Augmentum but my nose still felt the same and every morning I was stil coughing up green/yellow mucus (very bad every morning). I had no fever, no night sweats however I do feel warm all over my body, like a warm sensation but I have no fever

Sept 4th: I went to a ENT doctor (specialist) who prescribed Levoflexin. I took this antibiotic for 10 days with no improvements.

Sept 4th - Sept 10th: I took the Levoflexin but I did not help. I still was coughing up green/yellow mucus every morning from the post nasal draining back of my throat at night. During the day I do not cough much and do not see yellow/green mucus, no fever and no night sweats.

Sept 10th: I had a CT scan done of my sinusis. It showed no sinus infection however when the ENT did an endiscopy of my nasal passages he noticed my right side nasal passages as being really really inflammed. THere were no polyps or any of signs but just inflammation. The left side was a little inflammed but the right side was severly inflammed. This is when I told him about my teeth and that I thought I had some infected teeth on my upper right side (one being a molar). he told me my problems could be teeth releated

Sept 13th: I went to a family doctor who did a short check of my system. My temperature was normal (98.6), I had no fluid in my lungs and I did not appear to have any swollen lymph nodes

Sept 15th: I went to the dentist who did see a localised infection in my righ gum above the teeth I was having problems with. He put me on Amoxicillin. All this time I was still coughing up green/yellow mucus in the morning


Sept 29th: I had one of the infected tooth pulled on this day

Oct 3rd: I had to get on clotrimazole as I was getting a fungal infection since I have been on antibiotics for so long

Oct 7th: I had the other infected tooth pulled on this day. This tooth was very infected (actually the roots were black) and it penetrated into my sinus cavity. The oral surgen had to fill the hole where the tooth was in the sinus cavity.

Other key facts:
I have not lost any weight
I have not been running any fever
I have no night sweats
I do feel warm all over my body but I am running no fever for the past two months


===========================================================
Today is Oct 11th and I still woke up feeling very tired (I just do not feel normal) and kind of sickish and feel warm all over my body. My right jaw is swollen from the surgery this past Tuesday. Over the past month I've noticed that my right side of my neck/throat does not feel right (sore). THe dentist says this could be from the infection that was in there. The right side of my throat and neck is still sore. My glands on that side just feel a little bigger than my left side. I have noticed that I am not coughing up green/yellow mucus but I do have really bad sinus draining in the back of my throat. This is EVERY morning when I get up and just runs down the back of my throat for just the morning and then seems to go away. I feel sickish throughout the day, my nose feels really cold and I feel sort of nauseous. I have noticed of the past week my appetite is not where it has been and I'm feeling more nauseoues every day. Also, The other day I had a really bad headache which seemed to be above and between my eyes.

Here are my questions:

1) What I don't know is all of this coughing up yellow/green mucus in the morning ONLY (maybe related to post nasal drip overnight) over the past two months related to my teeth? Sinus CT scan was clear but ENT doctor told me infected teeth roots could irrate and cause inflammation in nasal passages along with the coughing up green and yellow mucus.
2) Why am I feeling nauseous and loss of appetite over the past week? Is it the medication I've been taking?
3) Do I seem to be getting worse?
4) Are there any negative counts in my blood test results that are attached? If I had a underlying illness would this show up in my blood test results?
5) I have noticed that I am not coughing up yellow/green mucus the past three days however I still have a lot of mucus coming up in the morning that I'm either coughing up from my lungs or its coming down the back of my nose in my throat from the post nasal drainage
6) Could I have some Virus in my system that is lasting this long and my body is trying to fight off?


Thank you, XXXX
doctor
Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)
Brief Answer:
It's more of allergic rhinosinusitis...

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for posting the query and an elaborate history. I'll make an honest attempt to help you with this problem.

1. Infected tooth can cause sinusitis. But, your CT scan was normal; this implies, the cause of the mucus discharge is the nasal inflammation rather than the infected tooth.

2. The blood tests are almost normal (even though the neutrophil counts are marginally higher). Hence, there seems to be no significant bacterial or viral infection.

3. Your nausea could be either due to the thick phlegm getting struck in the throat or post nasal drip.

4. Your symptoms are not getting worse. I feel, it's all the same. Antibiotics alone will not suffice. You will require the following:
a. A mucolytic such as ambroxol or bromhexine.
b. A steroid and a saline nasal spray.
c. Steam inhalation.
d. To drink plenty of warm water.
e. Avoiding chilled food & beverages/coffee/smoking.
f. To change your pillow cover every night before going to bed.

5. Secretions are more during the morning because of the it's accumulation in the most dependent part, that's the post nasal space. Regular steam inhalation will clear all these secretions.

6. I personally feel, it's more of allergic related rather than any bacterial or viral infection.

Hope I have answered your query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2542 Questions

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What Causes Coughing Up Of Green Mucus In The Morning?

Brief Answer: It's more of allergic rhinosinusitis... Detailed Answer: Hello Mr. XXXXXXX Thanks for posting the query and an elaborate history. I'll make an honest attempt to help you with this problem. 1. Infected tooth can cause sinusitis. But, your CT scan was normal; this implies, the cause of the mucus discharge is the nasal inflammation rather than the infected tooth. 2. The blood tests are almost normal (even though the neutrophil counts are marginally higher). Hence, there seems to be no significant bacterial or viral infection. 3. Your nausea could be either due to the thick phlegm getting struck in the throat or post nasal drip. 4. Your symptoms are not getting worse. I feel, it's all the same. Antibiotics alone will not suffice. You will require the following: a. A mucolytic such as ambroxol or bromhexine. b. A steroid and a saline nasal spray. c. Steam inhalation. d. To drink plenty of warm water. e. Avoiding chilled food & beverages/coffee/smoking. f. To change your pillow cover every night before going to bed. 5. Secretions are more during the morning because of the it's accumulation in the most dependent part, that's the post nasal space. Regular steam inhalation will clear all these secretions. 6. I personally feel, it's more of allergic related rather than any bacterial or viral infection. Hope I have answered your query; I'll be available for the follow up queries. Regards Dr. Naveen Kumar N ENT and Head & Neck Surgeon