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What Causes Coughing Up Of Greenish Mucus Discharge Despite Having Normal X-ray?
Question: I have had almost no voice, post nasal drip, fatigue, sore throat and cough with green mucus. Also sinus discharge of dark green in the morning then lighter during the day for the past 3 days. Chest X-ray and strep test were negative. I am gargling and using flonase and saline to clean my sinuses. Do I need an antibiotic? And how can one know if it's viral or bacterial or just allergies?
Brief Answer:
Antibiotic use justified in this case, infective agents could coexist
Detailed Answer:
Hi and thanks for the query,
It is great news already if the X ray and Strep tests are negative. I think the drugs prescribed are appropriate.
Greenish discharge is very suggestive of a bacterial infection, probably from an anaerobe. Pseudomonas aeruginosa, a bacterial infection often presents as such.It is not rare to do even cultures for bacteria that turn out negative under such circumstances, Considering the complications that could in case bacterial infection is not treated and this discharge, I think using antibiotics here are justified. Quinolones (class of antibiotics) are the drugs of choice in this case (ten day course, eg, Ciprofloxacine).
In case its viral, symptom control drugs (pain killers, aerosols, fever decreasing agents) should lead to alleviation within a couple of days. Allergies would need to identify a specific agent or environmental factor that triggers symptoms. A complete blood count could reveal raised eosinophils as well as raised Immunoglobuline R (IgE) in blood. Bacterial infections are more chronic, more serious, accompanied with colored discharge.
It is important to know that most do start as viral infections, and if left unmanaged appropriately, it renders the terrain favorable to harbor bacteria. Infections could there fore be mixed. It is very important to start symptom control from the very start of the illness.
Thanks and kind regards as I wish you the best of health,
Dr Bain
Antibiotic use justified in this case, infective agents could coexist
Detailed Answer:
Hi and thanks for the query,
It is great news already if the X ray and Strep tests are negative. I think the drugs prescribed are appropriate.
Greenish discharge is very suggestive of a bacterial infection, probably from an anaerobe. Pseudomonas aeruginosa, a bacterial infection often presents as such.It is not rare to do even cultures for bacteria that turn out negative under such circumstances, Considering the complications that could in case bacterial infection is not treated and this discharge, I think using antibiotics here are justified. Quinolones (class of antibiotics) are the drugs of choice in this case (ten day course, eg, Ciprofloxacine).
In case its viral, symptom control drugs (pain killers, aerosols, fever decreasing agents) should lead to alleviation within a couple of days. Allergies would need to identify a specific agent or environmental factor that triggers symptoms. A complete blood count could reveal raised eosinophils as well as raised Immunoglobuline R (IgE) in blood. Bacterial infections are more chronic, more serious, accompanied with colored discharge.
It is important to know that most do start as viral infections, and if left unmanaged appropriately, it renders the terrain favorable to harbor bacteria. Infections could there fore be mixed. It is very important to start symptom control from the very start of the illness.
Thanks and kind regards as I wish you the best of health,
Dr Bain
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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