Flu Symptoms: When to Seek Medical Attention

Influenza Issues

Hello, I am currently on the fourth day of my flu (symptoms started), and I took Tamiflu on the second day (previously saw a doctor and the medication did not help with fever reduction, then switched hospitals where a rapid test confirmed it was the flu, and I started taking it within 48 hours).
Since yesterday, I have started to have phlegm and nasal discharge, which is gradually becoming thicker (the nasal discharge has turned green and thick), and I have noticed slight blood-tinged sputum (very little) or sputum that is close to a light brown color, which I am having difficulty coughing up, possibly due to its thickness, so the amount is not much.
I have also already had a reduction in fever.
I would like to ask the doctor if this is considered a dangerous sign of the flu, or if it is a common phenomenon that I should observe for another day or two?

Natalie, 10~19 year old female. Ask Date: 2015/06/18

Dr. Chen Bozhang reply Family Medicine

Dear Natalie,
You mentioned in your message that you tested positive for influenza and have started taking antiviral medication.
You are experiencing thick nasal discharge and slight hemoptysis.
This could potentially be due to sinus inflammation, but pneumonia cannot be ruled out.
If the blood-tinged sputum is prominent, I recommend that you visit a hospital's pulmonology or family medicine department for a physician to assess whether further examination is necessary.
In addition to pneumonia as a complication of influenza, a secondary bacterial sinus infection may also present similar symptoms.
I hope this information is helpful to you.

Reply Date: 2015/06/18

More Info

When dealing with flu symptoms, it's important to understand the progression of the illness and when to seek medical attention. Based on your description, you are currently on the fourth day of flu symptoms and have been taking antiviral medication (克流感, which is likely oseltamivir) since the second day after diagnosis. You mentioned that you have developed phlegm and nasal discharge that has turned green and thick, along with a slight presence of blood in your sputum.
Firstly, it's common for flu symptoms to evolve over several days. The initial phase often includes fever, body aches, and fatigue, while the later stages can involve respiratory symptoms such as cough, nasal congestion, and the production of phlegm. The presence of green or yellow mucus can indicate that your body is fighting off an infection, as these colors often suggest the presence of white blood cells responding to infection. However, the presence of blood in your sputum, even if it is minimal, is a symptom that should not be overlooked.

In general, here are some guidelines on when to seek medical attention during a flu infection:
1. Difficulty Breathing: If you experience shortness of breath or difficulty breathing, this is a sign that you should seek immediate medical attention.

2. Chest Pain: Persistent chest pain or pressure can indicate a more serious condition and warrants a visit to the emergency room.

3. High Fever: If your fever persists above 102°F (39°C) despite taking fever-reducing medications, or if it returns after having subsided, you should consult a healthcare provider.

4. Severe Symptoms: If you experience severe headache, confusion, or persistent vomiting, these could be signs of complications.

5. Blood in Sputum: While a small amount of blood in sputum can occur, especially with severe coughing, it is advisable to consult a healthcare provider to rule out any serious underlying issues.

6. Worsening Symptoms: If your symptoms worsen after initially improving, this could indicate a secondary infection, such as bacterial pneumonia, which is a common complication of influenza.

Given that you have already started antiviral treatment and your fever has subsided, it is a positive sign. However, the development of thick, green phlegm and the presence of blood in your sputum should be monitored closely. It is advisable to contact your healthcare provider to discuss these new symptoms, especially the blood in your sputum. They may recommend further evaluation, such as a chest X-ray or a sputum culture, to rule out any complications.

In conclusion, while some changes in symptoms can be expected during the course of the flu, the presence of blood in your sputum is concerning and should be evaluated by a medical professional. It is always better to err on the side of caution when it comes to respiratory symptoms, especially following a viral infection like the flu. Keep monitoring your symptoms, stay hydrated, and do not hesitate to seek medical advice if you feel uncertain about your condition.

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