What are the Most Common Causes of Frothy Sputum?

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  • Originally Written By: Elizabeth West
  • Revised By: Jacob Queen
  • Edited By: Allegra J. Lingo
  • Last Modified Date: 18 November 2018
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Frothy sputum is usually a symptom of some form of respiratory distress. Frothing occurs when phlegm or mucus in the lungs combines with fluid and air, and is then coughed up by a person. This is a symptom of several serious conditions, including pulmonary edema, pneumonia, tuberculosis, and even plague. Generally speaking, any sickness that causes a lot of congestion in the lungs could potentially lead to frothy sputum.

Pulmonary Edema

Pulmonary edema is one of the most common causes of frothy sputum. This occurs when there is too much pressure in the blood vessels in the lungs, and they start releasing drops of blood into the surrounding tissue. This often leads to frothy pink mucus. Pulmonary edema is most commonly a symptom of congestive heart failure, a condition where the heart doesn't pump efficiently. It can also be caused by heart attacks, inhaling poisons, and near-drowning.


Thick and reddish, greenish, or yellow sputum is normally associated with pneumonia. A person with this disease will be very sick, feverish, have chest pain, and have a deep cough that produces phlegm. A medical professional can diagnose this illness by listening for a crackling in the lungs, which is called rales, and he or she may follow up with a chest X-ray. Pneumonia is treated with antibiotics or antiviral medications depending on the cause. Serious cases often require hospitalization.



White frothy sputum can sometimes be a sign of tuberculosis (TB). This condition can infect any part of the body, but is most common in the lungs. People with it have chest pain, night sweats, and a persistent cough, often with lots of phlegm coming up. Those with HIV are particularly at risk for TB because of their weakened immune system.


A less common cause of pink frothy sputum is plague, a severe infection caused by Yersinia pestis bacteria. It spreads via the bites of infected fleas found on rodents. Most people get the bubonic form of plague, which settles in the lymph nodes, and causes swellings called buboes. If the disease turns pneumonic, which means that it affects the lungs, fluid accumulates in the lungs and a person will cough up bloody sputum, spreading the bacteria through the air. During epidemics, such as the European Black Death in the 1300s, this condition spread rapidly in this fashion.


Generally speaking, any person with severe breathing problems and frothy sputum should seek medical attention right away. Respiratory disorders that become this serious can cause a person to drown in his or her own fluids; this can happen very quickly. Those with a weak immune system are often especially vulnerable to lung problems, and should monitor any symptoms very closely.


The treatment for the lung congestion issues that lead to frothy sputum vary depending on the cause. In cases of bacterial infection, a person will usually respond well to antibiotics, as long as the situation is caught early enough. If the condition is caused by something else, like heart failure or an injury to the lungs, there are emergency procedures that can help. This includes things like aspiration, which is the removal of fluid from the lungs using a syringe; and diuretic drugs, which can help clear up the lungs by removing fluid from the body. Some people even require surgery to clean out the lungs.

Severe breathing problems of this sort often require extended hospital stays, especially when the cause is something particularly dangerous, such as a heart disorder. Some people have to use an oxygen mask at least part of the time to help them breathe. In other cases, a medical professional may need to insert a breathing tube.


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