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The Ministry of Health of Cyprus "painted" the globe in green, orange, red and gray colors

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Green phlegm occurs with lobar pneumonia, chronic bronchitis and bronchiectasis, tuberculosis. Less often, the cause of the symptom is mycoses of the lungs, cystic fibrosis, and oncological processes. Thick green phlegm occurs in chronic sinusitis. For diagnostic purposes, instrumental (X-ray, CT of the lungs, bronchoscopy) and laboratory techniques (microscopic and bacteriological examination of sputum, blood tests) are used. The treatment plan includes antibiotics, bronchodilators, and expectorants. Sometimes oxygen support, surgical interventions are prescribed.

  • Causes of green sputum
    • Pneumonia

    Pneumonia

    Coughing up green phlegm is a typical symptom of segmental or lobar pneumonia. A purulent discharge with an unpleasant odor appears on the 2nd-4th day of the disease. The patient begins a painful attack of coughing, after which a moderate amount of sputum is released. For pneumonia, the discharge of pus "with a full mouth" is not typical, as in destructive lesions of the lungs.

    Coughing up sputum lasts 1-2 weeks. Gradually, the amount of green mucus decreases, the discharge becomes white-yellow, cloudy. In addition to this symptom, a person is worried about dull soreness in the chest, aggravated by coughing. There is a febrile temperature, general malaise, rapid breathing. Patients avoid taking deep breaths to avoid aggravating chest pain.

    Chronical bronchitis

    Green thick sputum is mainly separated in people who have been ill for 4-5 years or longer. In the bronchi, deformations are formed, which contribute to the stagnation of the mucous secretion and the reproduction of pathogenic microflora in it. For chronic bronchitis, it is typical to cough up green mucus in the morning after sleep. A person has a painful coughing attack, which ends with the release of sputum. During the day, the symptom is rarely worried.

    During the period of exacerbation of bronchitis, the volume of green sputum increases to 200-300 ml per day. Patients complain of increased shortness of breath, weakness and malaise. The body temperature is elevated. The cough becomes constant, combined with expectoration of thick yellow-green or gray-green mucus, which has an unpleasant odor. The exacerbation lasts 2-3 weeks, after which the amount of green sputum decreases.

    Bronchiectasis

    With this disease, stagnation of secretion occurs in the dilated and deformed bronchi, due to which it becomes infected with pathogenic bacteria. With exacerbations of the disease and cough paroxysms, a large volume of green secretion with a fetid odor is released. Enhanced discharge of mucus occurs after being in the supine position with the head end lowered or after breathing exercises.

    For the period of remission, scanty mucopurulent sputum of a green hue is typical, which is released by separate spits during a coughing attack. Those suffering from bronchiectasis have chronic hypoxia, so patients complain of increased fatigue, dizziness, deformation of the terminal phalanges of the fingers. If pathology occurs in children, a lag in physical development is usually detected.

    Chronic sinusitis

    In the paranasal sinuses, a thick green secretion is formed, which often flows down the back of the pharynx, causing a cough reflex. A paroxysmal cough is more often observed in the morning, immediately after waking up, since a large amount of discharge has time to accumulate during the night. The person is worried about pain and heaviness on the affected side of the face, headaches that worsen when the body bends forward.

    Tuberculosis

    A greenish tint of mucus is characteristic of an exacerbation of the disease and massive damage to the lung tissue or for the addition of a secondary infection. With tuberculosis, the symptom appears against the background of an increase in body temperature, intense chest pain, night sweats. Patients are disturbed by paroxysmal paroxysms of cough, accompanied by the release of scanty green sputum, which is distinguished by an unpleasant odor.

    Cystic fibrosis

    Symptoms of the disease are detected in childhood. In the bronchi, a viscous secret is formed in large quantities, which is difficult to cough up. The patient secretes phlegm after a prolonged, excruciating cough. The airways are cleared much better after being in a drained position. The discharge is thick and viscous, has a green or gray-green tint, and may contain individual mucous lumps.

    Often the pathology is complicated by bronchitis or pneumonia, the sputum becomes more liquid and acquires a yellow-green color. In addition to wet cough, patients are worried about shortness of breath, weakness, frequent inflammation of the upper respiratory tract (sinusitis, tonsillitis) with a specific clinical picture. With a mixed form of cystic fibrosis, digestive disorders are added.

    Mycoses of the lungs

    For fungal pneumonia, mucopurulent green sputum is typical, expectorant in small quantities. With aspergillosis, the discharge looks like dense, dirty green lumps mixed with mucus; with zygomycosis, the symptom is complemented by hemoptysis or pulmonary hemorrhage. Fungal infections occur with severe intoxication. An extremely serious condition of patients is characteristic of a mixed form of pneumomycosis, concomitant immunodeficiency.

    Malignant neoplasms

    With bronchopulmonary cancer, the symptom occurs during the period of tumor decay. The phlegm is profuse, dirty green or grayish, with a pungent fetid odor. Often in it you can see brown particles of the pulmonary parenchyma or blood streaks. A similar clinical picture is observed in cancer of the lungs or small bronchi. Germination of a tumor with involvement of the pleura is characterized by severe pain in the affected part of the chest.

    Diagnostics

    A qualified pulmonologist should identify the etiological factors that led to the release of green sputum. During the examination, attention is paid to the symmetry of the participation of the chest in the act of breathing, signs of pulmonary insufficiency, and characteristic respiratory noises are heard. Informative diagnosis of diseases is impossible without laboratory and instrumental methods:

    • X-ray examination.Radiographs of OGK in frontal and lateral projections show areas of inflammatory infiltration of lung tissue, zones of compaction, contours of neoplasms. CT of the lungs helps to visualize the structure of the organ in detail. To detect signs of bronchial deformation, bronchography is used.
    • Research of the FVD. For the diagnosis of chronic bronchopulmonary diseases, spirometry is shown, according to the results of which the vital capacity of the lungs, the volume of forced expiration and the degree of reversibility of changes are judged. To quickly assess the function of external respiration, the peak flow method is used.
    • Bronchoscopy. Visualization of the bronchial tree by the endoscopic method is needed in case of difficulties in differential diagnosis, with suspicion of a malignant process. The method shows the state of the bronchial mucosa, allows you to detect deformations, neoplasia. If necessary, a biopsy is taken using a bronchoscope.
    • Sputum analysis. Microscopic examination of the biomaterial assesses the content of blood corpuscles, the presence of bacteria or fungal spores. Be sure to do staining for acid-fast bacteria to exclude tuberculosis. Next, a bacteriological analysis of the discharge is performed.

    Additionally, a clinical and biochemical blood test is required, in which signs of an inflammatory process are found. To clarify the diagnosis, an MRI of the lungs is performed. To examine the surface of the lung tissue, diagnostic thoracoscopy is recommended. If green sputum is caused by an infection of the nasal cavity, an otolaryngologist is consulted with a rhinoscopy and X-ray of the paranasal sinuses.

    Help before diagnosis

    When purulent green sputum appears, it is very important to ensure that the airways are cleared of accumulated secretions. Patients are recommended to be in the position for postural drainage several times a day, to do breathing exercises. You can not take antitussive drugs that aggravate the course of the disease. Green sputum occurs with serious infectious or chronic processes, so self-medication is unacceptable.

    Conservative therapy

    Mild forms of chronic pathology are treated on an outpatient basis. Diseases that cause green sputum often dramatically worsen the patient's condition, so hospitalization is required. If signs of respiratory distress develop, oxygen support is provided. Etiopathogenetic therapy includes the following groups of drugs:

    • Antibiotics... They are prescribed to destroy pathogenic microorganisms that cause the formation of purulent green sputum. Antimicrobial agents are selected taking into account the results of bacterial culture. For the treatment of tuberculosis, special antibiotics are used in combinations of 3-4 items.
    • Mucolytics... Liquefy phlegm, so that it is easily removed when coughing and does not stagnate in the bronchial tree. To enhance the effect, secretomotor agents are added that stimulate mucociliary clearance.
    • Bronchodilators... Effective for chronic diseases accompanied by breathing difficulties. The drugs expand the lumen of the bronchi, so it becomes easier for a person to breathe, and sputum flows freely with a coughing fit.

    If standard measures are ineffective, they resort to bronchoalveolar lavage and aspiration of purulent secretions. When conducting medical bronchoscopy, intrabronchial administration of antibacterial drugs is possible. Of the physiotherapeutic methods, vibration massage of the chest, medicinal electrophoresis, and inhalation are actively recommended.

    Surgery

    With bronchiectasis, removal of the affected areas of the lung is performed - segmentectomy or lobectomy. In case of a complicated course of pneumonia with the development of zones of destruction, they are excised. With destructive forms of tuberculosis, cavernectomy, thoracoplasty, pleurectomy are indicated. For patients with lung cancer, surgery is the main treatment and is complemented by chemotherapy.

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