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The Scenario:
Enrique is basically a healthy guy. He plays soccer after work with no problems at all, and has never had any major health difficulties. He does smoke a bit -- anywhere from a few to five or ten cigarettes a day. Then one day he came down with a cold. First it was a sore throat and stuffy nose. Then it went into his chest and he developed a cough. He was coughing up a lot of yellow phlegm and had a low-grade fever, but overall didn't feel too badly. One morning he awoke, coughed, and noticed that he had brought up some blood. Later that day he again noticed some blood-streaked phlegm. Then it seemed to go away.
Questions:
Answer:
Coughing up blood can be a frightening experience. It conjures images of tuberculosis, lung cancer, and other scary possibilities. How concerned does one need to be?
That depends very much on the context of the situation. A 70-year-old heavy smoker who has had some recent weight loss, and who coughs up blood, should probably be evaluated for the possibility of lung cancer. On the other hand, a young woman, postpartum, who coughs up blood and is short of breath, will more likley be afflicted by pulmonary embolism (a blood clot that travels to the lungs).
In Enrique's case, he is young, healthy, and he has a chest cold. The inflammation of the bronchial tubes caused by the infection (otherwise known as "bronchitis") may be enough to cause a bit of blood in the phlegm. And that's the most likely answer. It is, however, one of those symptoms that should be communicated to your doctor so that he or she can think about whether or not any further testing or treatment is required.
As a number of "puzzlers" suggested, pneumonia is also a possibility. Others thought it might be from emphysema. Emphysema is due to scaring of the lungs from chronic smoke and dust exposure. Although it may be fatal (from an inability to get enough oxygen into the blood) it does not cause the coughing up of blood.
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