Coughing up blood

Category: Lungs & Breathing · All lungs & breathing symptoms

What it can feel like

Coughing up blood — anything from blood-streaked phlegm to larger amounts of fresh blood — is always a symptom to have assessed promptly. Most causes are treatable chest infections or inflamed airways, but because the list includes serious conditions, it should never be ignored or watched at home.

Possible causes

A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.

Common causes

Coughing up blood can be associated with vigorous coughing irritating the airway during a chest infection or bronchitis, with a nosebleed or bleeding gum being coughed back, and with bronchiectasis flares.

Other possible causes

It can also be associated with a blood clot in the lung, tuberculosis, pneumonia, and lung cancer — particularly blood-streaking that persists, or that occurs in someone who smokes.

Red flags — when to seek help promptly

Coughing up more than a few streaks of blood, or pure blood
Blood with chest pain or breathlessness — emergency
Blood-streaked phlegm that keeps appearing over days
Blood with weight loss, night sweats or a persistent cough

What a clinician may do

Assessment starts with observations and a chest examination. Blood tests and a chest X-ray are usual, and a CT scan of the chest, sputum tests or a camera examination of the airways (bronchoscopy) may follow depending on the amount and your risk factors.

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Frequently asked questions

It was only a streak — does it still matter?

Yes. Even a single episode of blood-streaked phlegm should be reported, and repeated streaking should be assessed promptly. The amount does not reliably predict the cause — small bleeds can come from serious conditions and larger ones from infection.

Could the blood have come from my stomach or nose?

Yes — vomited blood and blood swallowed from a nosebleed are often confused with coughed blood. Coughed blood is typically bright red, frothy and mixed with phlegm; your clinician will ask about this, because it directs which tests are done.

Related symptoms — Lungs & Breathing

Breathlessness Bringing up phlegm Chest infections that keep coming back Cough Noisy breathing Pain when breathing in

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Please note: This page is educational information about a symptom. A symptom alone cannot diagnose any condition, and the causes listed here are possibilities, not a diagnosis. If you are worried about a symptom — especially one that is new, severe, getting worse or not going away — please see your own clinician, who can examine you and arrange tests. In an emergency, call your local emergency number.