Can multi-coloured (pale greeny, yellowish, brownish with a bit of white froth) sputum really be negative for bacterial growths?

I sent an absolutely foul specimen of sputum away for analysis a couple of weeks ago and it has come back negative. I have been coughing this up for around 18months now and I had to suggest to the doctor that it might be a good idea to send away a specimen of sputum as it might show something up. I cannot understand how the filthy gunge can be normal. I went to see another doctor (the only one I could get) and she said that I was to send in another specimen for TB and microplasma. She made it clear that she did not think I had these conditions, (because they are rare) but wanted to cover all bases. By this time I was disheartened and said to her that I did not think I would go to the Consultant, because all the things she talked about I thought would show up on x-ray. She insisted I see the consultant because sometimes lungs and airways needed much closer inspection than I have had so far. Has anyone any experience of those other lung conditions.

Last edited by

32 Replies

oldestnewest
  • I have had a similar experience with a sputum test, disgusting yuck but nothing suspect was found. Juliekays recent post may give a clue. Good luck with the referral .

  • Thanks knitter, I'll have a look at the post you suggest.

  • Get all the tests and consultant you can Huggs. There are all sorts of lesser know conditions as well as the more well known ones.

    I would ring BLF regarding your sputum colour and what it might mean. I've been led to believe if there are shades of yellow & green something's up.

    I've heard of sputum colour charts to be found on line for comparison but not seen one.

    Good luck xx P

  • Thanks Peeg, I did in the end promise to keep my appointment with the Consultant. She did understand my level of frustration though, at how my chest x-ray could now be normal, bloods normal and sputum normal. The sputum chart sounds interesting and I will follow that up. If I find one on line I'll let you know. hugs xx

  • I agree with this recommendation. As soon as My sputum colours-up i start on my stand-by antibiotics. A safety=first move.

  • I imagine that your doc might have been meaning a CT scan when she mentioned "much closer inspection". As far as i know a gp can't order this test. It consists of about 36

    x-rays done in sections right through your lungs so it gives a hugely more efficient picture. My consultant requested one about 3 years after my initial copd dx and all the damage showed up which could not be seen on the x-ray.

    Peeg's right, the blf has a colour chart for shades of sputum - fifty shades of green ;). Sputum doesn't have to show bacterial infection just because it looks dreadful. Viral infections can produce pretty horrid sputum too. But we are all different and it's good your gp is being so efficient.

    You are lucky she is insisting on consultant appointment. Many people don't get that chance, and the way the NHS is going, they become much harder to get. Get it while you can huggs :) All the best.

    Edit: froth in my own experience is usually due to the asthmatic component of my condition.

  • Yes, 02trees the doctor did mentioned a CT scan and possibly a bronchoscopy. I just got frustrated when the sputum, blood and x-ray came back normal. I cannot for the life of me understand this, when I sleep half the day, cough up all the muck and gunge, am exhausted and have no appetite. Its being going on so long and, like us all, just want to know what is wrong and feel better. I do appreciate that there are many, many people far worse off than me so if I can be helped I'm going for it! Thanks again for your advice. hugs xx

  • Agree it could be viral infection ...apparently that's not a usual test ...normally sputum samples tested for bacterial infections only. Hope you push now for more tests to identify and so to treat it . X

  • Thanks for replying Julie, I really do appreciate it. The two conditions that I mentioned in my question are not usually tested for. I did not realise that viral infections were not routinely done. I think this is appalling and short sighted. I just assumed it was done as part of the test. I will be phoning my doctor after the Easter break. Have a nice Easter and I hope you are keeping well. hugs xx

  • Agree with Peeg and O2 huggs. You have a good doc and you need to be going to see the consultant for further investigations. xrays don't show up everything and as said probably a ct scan and/or bronchoscopy may be asked for. You are not gonna get any further until you see the consultant.

    Re the sample. The main guide is 'is the colour abnormal for you'? My norm is yellow/pale green, so that in itself is not an indicator for me. However if the colour is not your norm and you feel unwell there are a couple of reasons why you can get a false negative. I have had loads, one where the day after I ended up in 5* with pneumonia!

    1. It is not a bacterial infection. 2. It can have been taken from a part of the lungs which is not infected. 3 and I find this is almost always the reason - the sample is not in the petri dish quickly enough. Most of the bugs die off in about 3 hours (how wonderful would that be if they did that within our lungs). Check what time they collect samples and get your sample down shortly before - if you don't fill in your own MC&S forms, then give the nurses time to do this say 20-30 before the pick up time.

    If I were you huggs I would put another one in - try getting it from different areas of the lung, without spit if poss.

    Just a little point here. I never neb hypertonic before I put in a sample as I just feel it might interfere with the result and presently on BRUS someone is checking this out with a consultant. May ask mine as I am seeing him next week.

    Good luck hun and please be patient and don't get disheartened - these things take time to get a proper diagnosis - no point rushing in when the dx is not clear.

    Love cx

  • Thank you so much for your valuable advice and information cofdrop. Until Julie mentioned it I had no idea that sputum was not routinely tested for viral infections as well. The doctor has asked me to put in another sample which is to be tested for TB and something called microplasma. She does not think I have these conditions but just wants to make sure. I will phone her and ask about getting it tested for viral infections also. The sample has to be in the health centre before 11 a.m. because I live on an island and all the samples have to go off on the ferry to a mainland hospital. My sputum is also much worse in the morning anyway, so I'll leave it as long as possible. I must confess I have no idea whatsoever on how to get sputum from a different part of my lungs! Thanks again and I hope you have a Happy Easter. hugs xx

  • YW hun. cx

  • Cofdrop, How do you get a sputum from another area of the lung without spitting? all the mucus had only one channel to go through!

  • Firstly Mike sorry it has taken so long to reply - been away from home for Easter and computer.

    My message was misleading - sorry about that. When I text spit, I should have really text saliva.

    To answer you and huggs I can only really say the way I get sputum from different areas - you may both have a different method of clearance. I do pd with percussion and use the acapella too. I make sure I work on areas which I can feel are troublesome, but try to make sure I get some from the left and lower right (depends where your bronch is - mine is scattered and I also have a very troublesome area top right - usually when it shows up HI.

    Sorry if my reply sounded a bit vague (it's my age)!

    love cx

  • Hi cofdrop, Thanks for getting back to me. Don't worry about your message being misleading. You were only trying to help and for that I am grateful. The thing that did puzzle me was how to get sputum from different areas of the lungs. I am fairly new to all of this and have not been on a PR course yet, although I hope it will be soon. So I have not been shown how to do postural drainage and an acapella or flutter haven't even been mentioned so far. I do not see the consultant until the end of next month so things are not going to change before that. Hope you had a lovely time at Easter and keep well. hugs xx

  • I wouldn't think they would do anything on pd on a PR course. They didn't when I went. PR is excellent re exercise but it is in the main designed for copd. They did cover inhalers and the flutter, but really your consultant should refer you to a respiratory physiotherapist who will go through the techniques and gadgets. They may not go through pd unless you specifically want to know, as it is apparently considered 'old hat', but then I am an old lass and have been doing it for 65 years now, and like lots of bronchs I know suits us. With the help of your physio you will find what works best for you.

    You can get a flutter from your GP, although he/she might not be aware of that!

    Good luck sweet.

    love cx

  • Hi again cofdrop, I probably have not made my position clear. Sorry, if I haven't. I have been on this site asking a number of questions and I sometimes forget to say the facts as I have written them so many times already. I have had asthma for around 12 years and have just been diagnosed with copd. My GP also thinks I may have bronchiectasis which is why I have to see the consultant. I have read so much and asked so many questions I think I may have confused myself! I also have memory problems due to epilepsy, which does not help when you are learning something new and apparently complicated. I hope when I see the consultant he will clarify my needs as I am sure (or hope) that I will not need everything that I hear about.!! Thanks again for all your help and take care. hugs xx

  • Hiya c, my most troublesome spot is top right too, yeh must be the wretched HI.

    I have this thought that the HI is resident in the nasal passages and post nasal drips down to where the 2 lungs divide from the bronchial tube, that's where it pools for me and causes mucus to form.

    When I do pd (postural drainage) there is a better result when lying on my left side but I flip over several times for best result.

    su x

  • Well Su it can piddle off somewhere else, 'cos it drives us bonkers.

    With love Cx

  • I suffered with a similar thing, it was only when the consultant asked the lab to check for some unusual bugs that take a while to grow that they discovered two mrsa type bugs living in my lungs. Thank God for a very good and determined consultant who would not take no for an answer, he has killed one bug the other defies all antibiotics (a member of the TB family but not TB as such) and produces yellow / brown sputum.

    He arranged series of cat scans and because of the results from those is investigating the possibility of a fungus ball growing in one lung.

  • That sounds dreadful moneal. As you say, thank God for an excellent consultant and you are at least part of the way there. My GP has asked me to hand in another sample of sputum for TB and microplasma. She does not really think I have them but is covering all the bases. I have to get a CT scan and possibly a bronchoscopy. Keep well, and I hope they get the rest of your problems sorted out soon. Have a Happy Easter. hugs xx

  • Hi,

    Sorry to say it, but this doesn't surprise me in the slightest!

    I suffer from Chronic Sinusitis, and get repeated respiratory infections. On a number of occasions, I have produced nasty, greenish-yellow mucus. I have reported this fact, and my Doctor hasn't even been bothered to investigate - I have just been "fobbed off" with the statement "it's viral"!

    On a further occasion, I had a dreadful infection which started in my sinuses, and rapidly spread. I was very unwell - lethargic, sweaty, clammy, and had a hacking cough. This produced foul, brownish sputum - thick and bubbly. I was also off my food, and vomiting. This is one of the few times my Doctor bothered to send off a sample of sputum. Oddly, it came back as having identified nothing!

    I can totally agree that this is extremely disheartening. Personally, I think it stinks of incompetence on the part of medical staff. Either that, or disinterest!

    In my case, I now understand the reasons for the problem to be as follows -

    1. My greenish-yellow mucus was never sent off for investigation. The G.P. I was under at the time had a habit of "diagnosing" over the telephone, without even seeing a patient face-to-face. Because I had a history of sinusitis, she would simply dole out antibiotics over the telephone! Thus, there was never an opportunity to get a sample tested. Simple reason - lazy G.P.

    2. Sputum from my chest infection, which was brownish, WAS sent off for investigation. However, by this time, I was almost three weeks into a protracted infection. I had also been started on Antibiotics (Erythromycin) by this time. NOBODY gave any advice as to whether it was correct to collect a sputum sample AFTER a patient had been started on medication. I can only suppose that the Antibiotics had already begun to destroy any bugs present - and this messed up the sample test results.

    I would seriously advise that you persist in trying to get answers. As far as I am aware, change in colour of mucus or sputum is clearly indicative of infection and/or other problems. When I say other problems, I mean that people do not only get infections caused by BACTERIA or VIRUSES. Some respiratory conditions, especially chronic ones, can be caused or exacerbated by FUNGUS - particularly ASPERGILLUS. Additionally, if you have experienced bleeding somewhere in an airway, mucus or sputum can come out pinkish, streaked with blood, or even brownish (as a result of old blood).

    Furthermore, you will probably KNOW if you have an infection of any sort. Your mucus/sputum alone need not indicate this. Evidence from other symptoms gives a clearer picture - achy, shivery, lethargic, tender glands - symptoms such as these can provide further evidence that all is not well, and that infection is present (and highly active).

    I've provided some links to articles that give details of different types of infection, and signs - including changes in mucus/sputum colour. Also some info about fungal infections. The links are...

    nhs.uk/conditions/aspergill...

    blf.org.uk/Conditions/Detai...

    mucuscolor.com

    The last link is to a pretty comprehensive site. I am sorry that it is American, but it tells you all you really need to know (in some detail, but in plain language) about mucus/sputum colour and links to infection.

    I do hope that this helps, and that you are able to get something sorted out. I wish you a safe recovery.

    All the best,

    E.

  • Hi Scooteeder, Thank you for providing me with such informative advice, information and helpful pointers. It must have taken you ages to do this and I am very appreciative of that. I am sorry you have had a hard time and hope things are a bit better now.

    Years ago I use to suffer from chronic sinusitis, but thankfully do not have that to contend with now. I am appalled at the way they appear to treat sputum samples and from what I have learned today I am no longer that my specimen came back negative.

    I never coughed up sputum until around 18 months ago which I put down to some upper respiratory tract infection and it has just got worse. Last night was the first time that I coughed up brown sputum which was mixed in with the green and yellow. I have to send off another specimen and see a consultant. I hope you keep well, and I can't thank you enough for all the information. Have a Happy Easter. hugs xx

  • Hi again...

    Apologies. Cannot explain why the last link has not activated. It is correct, and I have spelled it correctly. Please just try typing it into a search engine. It is, as I have written...

    mucuscolor.com

  • Huggs this does sound strange, we are advised that change of sputum colour is usually a sign of a problem in the lungs. So if I was you I would still see the consultant as there are so many lung and chest conditions with similar symptoms you need specialist investigation to determine what is wrong. Good luck

  • Hi Katie, Thank you for replying. I will see the consultant and do as I am told. There is definitely something wrong other than asthma and copd. I will just have to be patient a bit longer. Happy Easter and keep well. hugs xxx

  • On the other hand, I have the experience of sending a sputum that, to me, didn't jump out of the ordinary, but the microbiologist found in it the trace of Mycobacterium, this is TB. yes, it's rare, but with weak lungs, it can infiltrate in the alveoli mucus. Have a second test.

    And no, the mycobacterium isn't necessarily seen on the XRay. Only advance TB, can be seen where you have cavities. You don't want to reach that stage, brother!

    What the XRay shows are distorted lungs, (I've seen this as a sort of mist and darkening in my lungs to show bronchiectasis). The disadvantage of XRays is that it goes through very soft tissue and liquid, so the sputum wouldn't show.

    Here is part of the NHS website info on Xray tests:

    Chest examination

    Major organs and blood vessels don't show up as clearly on X-rays as bones, but they are visible. A chest X-ray is therefore a good way of identifying changes or abnormalities in your heart, lungs and major arteries.

    In particular, chest X-rays can help diagnose:

    heart conditions – such as heart failure, congenital heart disease and pericarditis (inflammation of the heart lining)

    lung conditions – such as pneumonia, lung cancer and chronic obstructive pulmonary disease (COPD)

    nhs.uk/conditions/x-ray/pag...

    Hope it informs you .

  • Hi Mic, Thanks so much for your long and helpful reply. I have to hand in another specimen of sputum which is to be tested for TB and microplasma. She (the doc) does not really think I have these conditions but wants to make sure before I see the consultant. Thanks also for the link which is very helpful as well. I hope you are keeping not too badly and have a very Happy Easter. hugs xxx

  • Hello Huggs. I would reiterate what others have said - you need a consultant referral. I suffered with a cough like yours for three years along with permanent tiredness etc.... And never had a sample come up with any results. I gave up in the end but a locum at the GPs heard me cough and insisted on a referral. The CT scan I eventually had showed bronchiectasis, for which I now have successful treatment. So do be persistent.

  • Thank you monkey. I do realise now that I will have to be extra persistent sometimes. I don't have a great deal of faith in doctors, or probably more correctly, the system. This means I get easily discouraged with them. Now I know that it appears to be more or less normal to get a negative sputum result, and its not just me, I will carry on and do what is asked of me. I am known to be stubborn and persistent so hopefully things will work out soon. Have a Happy Easter and I hope you are well at the moment. hugs xx

  • Negative for what?

    Was the test done via your GP / hospital clinic?

    Doesn't sound normal to me and anything greenish indicates it isn not 'normal'!

    Go back to your GP / hospital clinic and ask them to explain to you why it is greenish, at the very least you are entitles to a proper explanation.

  • Hi termite,

    Thanks for replying, and its nice to hear from you. I have given two sputum samples to my GP who sent them off to a mainland hospital. ( I live on an island) Both came back negative. I was suppose to see a respiratory consultant at the end of May, but had to cancel due to an infection, and still have no new appointment. However, the colour of my sputum is much healthier looking, and by the time I get to see the consultant I will probably be much better. I don't cough up as much and is now frothy white, with a pale, yellowy green tinge to it. On saying that it has been a deeper shade of green yesterday and today.

    I had a terrible experience with a GP last week, and was so upset that I spoke to the Practice Manager, and put my points and remarks made by her down in writing. So a formal complaint procedure has now been implemented and I am meant to hear from her within 10 working days of receiving the letter, which she would have got on Monday. I am now quaking in my socks, in case I need to see someone before all this other stuff has been sorted out. Due to the very extreme, violent and prolonged coughing which lasted a year, I now have neuralgia on my head and neck problems. Its agony to cough or even sneeze!

    I have given up on GP's at the moment, and will wait until I see the consultant and have a ct scan.

    Thanks so much for your concern, and am glad to report my sputum is not as disgusting as it was. Hope it stays that way. I hope you are not too bad yourself. Take care, hugs from Huggs xx

You may also like...