The color of sputum or phlegm, which is the mucus and sometimes pus discharge expectorated from

the respiratory tract, is often an indication of the type of respiratory disease that gives rise to sputum
production. By examining the type of sputum and noting the color as well as the presenting signs and
symptoms, a differential diagnosis may be reached prior to laboratory tests and examination sputum
cytology and culture. A thorough case history and complete physical examination is also necessary.
Ideally, the morning sputum specimen should be examined as this provides a more vivid indication of
the cause. Sputum samples that are coughed or spat up during the course of the day may lack the
features that would provide a clue to the disease process and be tainted by foods and drinks, especially
those rich in artificial colorants.

Meaning of Different Sputum Colors

As mentioned under the Types of Sputum, the discharge is a combination of mucus produced in the
respiratory tract and saliva from the mouth. It also contains microorganisms, immune cells, cellular
debris, dust and possibly even blood components or whole blood (plasma and blood cells). Depending
on the quantity of these components and disease process, the sputum color may vary between :

Clear
White
Gray
Yellow
Green
Brown
Pink
Red
Rust-colored
Black

Object 1

ALB primul raspuns al corpului

VERDE inseamana lupta activa
GALBEN inseamna leucocite moarte, posibil bacteria castiga batalia

Clear, White, Gray Sputum

Clear sputum is considered as normal, however, there are many conditions that may cause excessive
sputum production. A profuse amount of clear sputum should therefore be considered as abnormal.

Pulmonary edema (fluid in the lungs) clear, white or pink frothy sputum
Viral respiratory tract infections clear to white (acute)
Chronic bronchitis (COPD) clear to gray
Asthma white to yellow (thick)

Yellow Sputum
Yellow colored sputum is due to the presence of white blood cells, particularly neutrophils and
eosinphils. These cells are often present in chronic inflammation, allergic and infectious causes. With
infections, it is often in the acute setting that yellow sputum is evident due to the presence of live
neutrophils. With allergic conditions, particularly airway hypersensitivity, the yellowish sputum is due
to the presence of eosinophils.
Acute bronchitis white to yellow
Acute pneumonia white to yellow
Asthma white to yellow (thick)

Green Sputum
Green mucus is indicative of a long-standing, possibly chronic, infection. The color is a result of the
breakdown of neutrophils and the release of verdoperioxidase / myeloperioxidase, an enzyme that is
present within these cells. It may also be seen in long standing non-infectious inflammatory conditions.
With infections, the green sputum will be more purulent (large amounts of pus) while in noninfectious inflammatory conditions, the green sputum will be more mucoid (large amounts of mucus).

Pneumonia white, yellow or green

Lung abscess green, sudden accumulation of large amount of sputum if the abscess ruptures
Chronic bronchitis clear, grey to green (infection)
Bronchiectasis, cystic fibrosis green

Brown and Black Sputum

Brown or black sputum is an indication of old blood and the color may be due to the breakdown of
red blood cells thereby releasing hemosiderin (from hemoglobin). Certain organic and non-organic
dusts may also cause a brown to black discoloration of the sputum.

Chronic bronchitis green, yellow, brown (infection)

Chronic pneumonia white, yellow, green to brown
Coal workers pneumoconiosis brown to black
Tuberculosis red to brown or black
Lung cancer red to brown to black

Red, Pink and Rust-Colored Sputum

Red sputum is usually an indication of whole blood that is more profuse than bleeding in pink colored
sputum. It may completely discolor the mucus or appear as streaks or spots. Pink sputum is also a sign
of bleeding but usually of smaller quantities that may stain or streak the sputum. Rust colored sputum is
also due to the bleeding although the clotting process may have commenced and the red blood cells
may have broken down.

Pneumococcal pneumonia rusty-red

Lung cancer - pink to red (frothy) progressing to brown or black
Tuberculosis bright red streaks progressing to fully red sputum (hemoptysis)
Pulmonary embolism bright red blood (acute)