Aside from the copious purulent sputum, not bad!

December 4, 2023 3:13 PM

Two days after Thanksgiving, I came down with a sore throat and fever, which turned into a cough. The fever was gone by day 4 but the cough was getting worse. Oddly, nobody in the 20+ group of people I saw around thanksgiving was sick, or has fallen sick since.

On day 5 I coughed up thick green mucus with fresh red blood spots in it, and I decided to go to urgent care since that doesn't seem like a great sign.

All my tests were normal: temperature, pulse oxygenation, chest xray, and a nasal swab w/PCR tests for Flu, RSV, Covid and Pertussis.

I asked if they wanted a sputum sample but they didn't seem interested.

I was prescribed Tessalon Perles and Codeine cough syrup, which have helped me sleep better, but the cough continues.

Now at day 9 I'm feeling relatively normal except for this horrible cough which is bringing up all this phlegm. Each morning I'm coughing up about a tablespoon (15ml) of goop that has the consistency and color of pea soup.

During the day I have hacking coughing fits where I cough up smaller amounts, ranging from bright green to darker green. My nose is also running, but the discharge is clear.

I'm not in any distress, mostly just mystified as to what this is, as I've never had this combination of "mostly feeling OK" with these dramatic symptoms.

Non-smoker, don't have athsma, do have GERD but it's been well-controlled lately, I am a teacher so could have been exposed to pretty much anything. I did some yard work 3 days before I came down with this. Live in Southern California.

I was under the impression "green phlegm = bacterial infection" but it seems like that may old-fashioned thinking?

Thinking I might go back to see the doctor if this doesn't start getting better in a few more days, but I'm curious if anyone has any ideas.

posted by soylent00FF00 to Health & Fitness (10 answers total)

Not sure where you are, but I read last week that Mycoplasma pneumoniae is going around in Ohio, and separately, in a few other countries also. Here's a WaPo article about it. It seems from the CDC page on mycoplasma like that could cause a chest cold. But that's just one random thing that I saw in the news and I imagine it could be a trillion other things too. I know there are some nasty fungal infections you can get from old piles of wood, although in my collection of anecdotes that's more like "backwoods beaver dams" and less like "the kind of brush pile you might have on your property."

Assuming you are teaching through this illness, as most teachers do, you would be doing your students a kindness if you wore a mask while this is still brewing, whatever it is. (This is not endorsement of working through illness, a cultural practice I really dislike, just an acknowledgement of the constraints you might be under.)

Edit: reread, saw you're in SoCal. Probably not the Ohio outbreak then!
posted by eirias at 3:29 PM on December 4, 2023

I've had similar symptoms (most recently this year at the end of October) when I've had a bad cold that turned into (viral) bronchitis - after a week, all the other symptoms are mostly OK, but I've still got a very bad, very productive cough. Usually, just as I'm thinking "If I'm not getting better in a few days, I'd better go to the doctor," I start feeling better. Hope you have similar luck!
posted by Jeanne at 3:33 PM on December 4, 2023

Have you had a chest xray? You may have pneumonia. Pretty simple and diagnostic.

I hope you are better soon!
posted by citygirl at 4:20 PM on December 4, 2023

Highly anecdotal, but my doctor never cares what color the mucus is and looks annoyed if I tell her.
posted by chocotaco at 4:36 PM on December 4, 2023

Yeah the mucus color isn't meaningful. This could be a bad chest cold, pneumonia, or bronchitis. You could reasonably ask for a chest x-ray, but I'd probably just rest and hydrate for a couple more days rather than going in to wait in a waiting room with a bunch of other people who have viruses.
posted by potrzebie at 6:28 PM on December 4, 2023

I think the color indicates infection. Call your doctor's office, ask them for advice. Not to sound like a mask-denier (I'm not) but we have immune systems that usually work,so Urgent Care gave you some basic care. The persistence of this means you need more, better, care.
posted by theora55 at 7:19 PM on December 4, 2023

Just a note that OP reports already getting a chest X-ray at urgent care, which was clear.
posted by blue suede stockings at 4:45 AM on December 5, 2023

Sounds like you're experiencing what they call post viral cough, which unfortunately can last up to eight weeks! It's super annoying, but since you've had a clear chest x-ray, and as long as you don't have fever, worsening fatigue, or shortness of breath at rest (seek care again if any of that happens), it is probably going to resolve on its own with good supportive care at home. You can keep using your benzonatate/Tessalon perles as prescribed, if you find that helpful for sleep. Make sure to drink lots and lots of fluid, preferably WARM. Honey in tea is magical, and you might find slippery elm lozenges soothing and cough-suppressing to a degree (I like these ). If you're only on day 9 since beginning of symptoms, I would also caution against doing too much activity-you still need more rest than usual. I hope you feel better soon!
posted by little mouth at 5:33 AM on December 5, 2023

I picked up a less bad cough about a week before Thanksgiving with “feelings little tired” as the only other side effect. It stopped two days ago. You may just need to give it time.

Warm showers every morning and attempts to increase the humidity helped me a bit, but my cough was drier than yours.
posted by A Blue Moon at 6:12 AM on December 5, 2023

Thanks for all the ideas - a friend sent me this link which suggests it's viral and widespread.

Since yesterday, my housemate is coming down with what appears to be the exact same thing.

I'm doing about 5% better each day, so it sounds like "give it time" is probably the best solution.

I'm very curious (assuming this is a virus) - what virus family is it?
posted by soylent00FF00 at 2:31 PM on December 6, 2023