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sputum (phlegm)
Characteristics:
1) mucoid sputum: translucent, white or gray
2) purulent sputum: yellow or green (may be large volume)
a) bronchiectasis
b) lung abscess (foul smelling)
3) mucopurulent: components of both mucoid & purulent sputum
4) yellow-green sputum production may be due to acute bronchitis
5) frothy pink sputum: pulmonary edema
6) current jelly sputum (sticky, red):
- characteristic of Klebsiella pneumonia
7) bronchial casts, mucous plugs & thin strings seen in
a) asthma
b) bronchopulmonary aspergillosis
c) mucoid impactation syndrome
Laboratory:
1) sputum gram stain & sputum culture
3) acid fast stain & mycobacterial culture if indicated
4) microscopy for eosinophils, Charcot-Leyden crystals & Curschmann's spirals in asthmatics
Management:
- excessive, thick sputum
- keep air moist, drink fluids
- gargle with salt water
- guaifenesin thins thick sputum
- dornase-alfa is mucolytic
Related
bronchorrhea
culture of sputum
sputum cytology
sputum gram stain
Specific
blood-tinged sputum
foul-smelling sputum
General
body fluid
References
- Guide to Physical Examination & History Taking, 4th edition,
Bates B, JB Lippincott, Philadelphia, 1987
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 719
- Medical Knowledge Self Assessment Program (MKSAP) 15,
American College of Physicians, Philadelphia 2009