Meaning of Different Sputum Colors

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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.

Depending on the quantity of these components and disease process, the sputum color may vary between :

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 sputumis 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 non-infectious 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)
  • Bronchiectasiscystic 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 worker’s 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)

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  • Charlene Horvereid

    What if my sputum is clear but there are tiny dark greenish speckles, is that normal? I smoke a little too.

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  • When I bring my mucus up its a clear and cloudy with brown in

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  • Liz Chapman

    i have different colored sputum, sometimes it iss like a light pink slug, sometimes green. i also hav a cottage cheese tyoe sputum with grey blobs surrounded by a clear sack, the other type almost looks like a culture screen they seem flat with a outside color of rust. i only have a wheeze but mostly ay night, and an almost popping or clicking sound. also at times i have flesh colored small like branches. or twigs. i have IMMUNE deficiency disease, as well as being highly allergic to mold. i will also what i would call regurgitation and throw up a very small amount of brown to black color. sometimes sputem is orange. two months ago i had so muchnloating in my stomach i looked like i was 8 months pregnant. the pressurewas so bad i made myself throw up, this is very gross,(do not read if squimish) it took several tries i would feel stuff in my throat but it was like stuck. then it started xoming up, long worm like objects thick with mucous some were tan, aome grey and covered in mucus and blood it was so much i almost chocked on kt, i was winding them around my hand like u would yarn or something. i could feel resistance and rugged and pulled with steady pressure thats when i must have detached what ever rhey were from my stomach lining, rhen the heads started appearing, i didn’tthink u would be abke to see them but they were huge and it was like a horror movie think DUNE the mouths were covered in nlood and tissue. i lost 11 lbs in one day filling up a gallon zip lock bag, i coulsnt video or take a photo as one hand had these things wrapped around them and the other hand covered in alime and pieces that had broken off. i looked at a photo of acricas round worm and i think those were some of the things. i can get absolutelyno help from Dr’s at all. i was treated for Candidaand it helped for awhile. now my belly is starting ro bloat again. they did at one time try and perscribe a medicine but it was $4000.00 and insurancewould not cover. i tey and use hwrbal remidies and they help to a certian extent. please help aomeone anyone. i am also highly allergic to mold.