Every day I cough up what looks like a scab with ugly mucous and blood

Posted by needtoknow @needtoknow, Feb 10, 2016

Every day I cough up what looks like a scab with ugly mucous and tiny amounts of blood. It seems to come from the back of my throat or nose. My doctor has seen the scab but does not see anything wrong. This, to me, seems really odd. Has anyone had this problem?

Interested in more discussions like this? Go to the Ear, Nose & Throat (ENT) Support Group.

@searchingforrelief

Hi Jfvero, I’m interested in knowing if you are still feeling recovered. Also, please share the name of the Specialist from Penn Med who was able to diagnose and prescribed you the meds.

Jump to this post

Searchingforrelief -- I private messaged you the contact information several weeks ago ... checking to see if you were able to make contact

REPLY
@brittany2021

I too have been having the same problem for two years now ,every morning it’s the same mucus just lying in my throat ,sometime it forms so hard and crusty it’s hard to hack up!Iv been to the doctor too may times and I’m now only getting my ent appointment, the doctor Kept saying it’s possible reflux but medication didn’t help ,also had multiple nasal sprays ,antibiotics,antihistamines ,it always lodges it’s self on side of my throat ,also the side my throat always feels very irrated it seems the pain comes kinda Above one tonsil that no doctor seems to understand why ,it’s so frustrating and now causing problems with my eating as it feeling like my food always getting stuck with my mucus

Jump to this post

Welcome to Mayo Clinic Connect, a place to give and get support.

That's tough when you've been to the doctor so many times and you still don't have a solution.

May I ask if you went to the same ENT each time or did you see second opinions?

REPLY
@sarahbrhein

Hello all, thank you for posting about this topic... I too am plauged with the crusty greenish yellow circular phlegm balls that I have been coughing up every other day. This has been happening to me for almost 3 years, but gotten much more frequent with time. My doctor cultured my phlegm and it came back as heavy growth staph areus (not mrsa) with rare white blood cells seen and many gram positive coli. I was put on 300mg of clindamycin 3x a day for 10 days. Immediately the coughing of these nasty things stopped and I could finally rest my throat. However, 6 days after antibiotics were over (yesterday) the darn thing was coughed up again 🙁 now, it looks much clearer and a little smaller than before, but still concerning and has the darker spot in the middle. It's really hard too in the center.

Today I saw my ent for a endoscopy (he saw the phlegm sitting near my antenoids near the nasopharynx far back in my nose in the center of my head.) He then did a sinus CT which he said showed nothing abnormal... He isn't worried about this ball of phlegm and said I do not have a sinus infection. He said it's common for staph to collect in the nose. I seriously don't understand why the antibiotics stopped this while I was on them if it wasn't an medical worthy bacterial infection?? He won't give me antibiotics for longer because he's afraid of side effects like c diff and said I don't need it. :/ I told him I literally cannot live with this forever, as it hurts to hack this stuff up. He then replied that he can offer a biopsy of the area that will check the cells as well as culture the samples and he will clean the area with antibiotic ointment. I seriously doubt this is going to help, but I am out of options and just want it to be over with so I agreed to do it next Wednesday.

Has anyone ever had a remedy to this madness? I am at my wit's end. To make things even more interesting, my left eyelid is dropping and started around the same time as this mucus issue. My neurologist 2 years ago said my MRI was normal and I am fine. So it's normal to cough up phlegm balls and have a sagging eyelid at age 30? Someone PLEASE help lol ........

Jump to this post

Hello everyone, thank you for the replies, I just wanted to provide an update. Since posting, I've had a biopsy of my nasopharynx where the andenoids are. I was told there is no cancer, but my tissue tested positive for a bacteria called Eikenella Corrodens. My ENT told me this diagnosis is perplexing to him because many people normally have this specific bacteria in the nose naturally, but not necessarily in the actual tissue (from the sample of skin he took out). I have already taken a round of clindamycin for 10 days due to my crusty phlegm sample testing positive for heavy growth staph areus. Now, my ENT says he thinks he'll prescribe me a second round (now a month later) because the Eikenella is resistant to Clindamycin and I'll now be taking Augmentin. I don't know if perhaps this is a co-colonizatiom between the two bacterias? Or, all part of normal flora and is just a coincidence and I just a nasal irrigation issue... or both. Since my biopsy, I have only coughed up just 1 phlegm which was super bloody from the biopsy but it's been a week and nothing since. I plan on waiting till I cough up another one and then start the 2nd round of antibiotics while starting nasal irrigation twice daily as many of you have recommended. Thank you all for the feedback, please let me know if any of you have a similar diagnosis or thoughts about the Eikenella in the nasal tissue! I am also scared to take antibiotics because clindamycin is strong and that was just a month ago so I might wait a little....

REPLY

I have had the exact same issue consistently for 2 years straight. I've had it off and on for several years before that, usually a lingering side effect from a cold or strep throat, but it would effectually go away. Not this time. I have no sinus issues, but I no longer have tonsils and get strep throat every few years (my doctor thinks one of my kids is a carrier). I have not been on antibiotics for over 3 years, so i can't rule out a long term bacterial issue. (Not even sure if they can linger that long?).

I am convinced my Silent Reflux is the current cause of my excess mucus. I also think those of us that have this dried plug form have a particular spot to harbor it, that maybe others don't. It's a bit of a perfect storm, which is why it may not be as common as it should be. I plan to see a Naturopath about my reflux, as i don't want to use the medication.

One tip i wanted to share is an easy way to dislodge the scab/ plug. Gargling! I lean my head waaaay back and gargle with warm water, almost swallowing it at the end. This could mean my "spot" where the scab forms is lower than other people's spot. Mine is right at the very bottom of the nasal cavity, right around the eustachian tube oriface. Hacking doesn't work (that brings stuff UP)... it needs to be brought down with a snort, and then coughed up. It almost feels like i just need to get it around a "corner" - like it's forming on a ledge. And it's attached to the ledge with very thick, sticky mucus, like glue! It's no wonder it can be hard to dislodge! But the gargling works. And so much relief afterwards! Until 2-3 days later when another one forms.

Interestingly, when I talk a lot - like in the phone, it dislodges itself! So the response to larynx activity suggests that it could be forming on, or very close to, my larynx. Sometimes it's slid down my throat, because I'm unable to get to a bathroom to cough it up. That is not fun!

Anyway, I'll post again after I've been to a Naturopath. I hope the gargling helps some people!

REPLY

Hello @pokee and welcome to Mayo Clinic Connect. Thank you for joining this conversation and providing support to others who have similar experiences and for the offer to come back and provide an update following your Natropath appointment.

How can members support you best?

REPLY
@pokee

I have had the exact same issue consistently for 2 years straight. I've had it off and on for several years before that, usually a lingering side effect from a cold or strep throat, but it would effectually go away. Not this time. I have no sinus issues, but I no longer have tonsils and get strep throat every few years (my doctor thinks one of my kids is a carrier). I have not been on antibiotics for over 3 years, so i can't rule out a long term bacterial issue. (Not even sure if they can linger that long?).

I am convinced my Silent Reflux is the current cause of my excess mucus. I also think those of us that have this dried plug form have a particular spot to harbor it, that maybe others don't. It's a bit of a perfect storm, which is why it may not be as common as it should be. I plan to see a Naturopath about my reflux, as i don't want to use the medication.

One tip i wanted to share is an easy way to dislodge the scab/ plug. Gargling! I lean my head waaaay back and gargle with warm water, almost swallowing it at the end. This could mean my "spot" where the scab forms is lower than other people's spot. Mine is right at the very bottom of the nasal cavity, right around the eustachian tube oriface. Hacking doesn't work (that brings stuff UP)... it needs to be brought down with a snort, and then coughed up. It almost feels like i just need to get it around a "corner" - like it's forming on a ledge. And it's attached to the ledge with very thick, sticky mucus, like glue! It's no wonder it can be hard to dislodge! But the gargling works. And so much relief afterwards! Until 2-3 days later when another one forms.

Interestingly, when I talk a lot - like in the phone, it dislodges itself! So the response to larynx activity suggests that it could be forming on, or very close to, my larynx. Sometimes it's slid down my throat, because I'm unable to get to a bathroom to cough it up. That is not fun!

Anyway, I'll post again after I've been to a Naturopath. I hope the gargling helps some people!

Jump to this post

Reply to pokee : you wrote the most accurate description I've seen. It does feel just as you describe. I too sense there is a spot, crevice that it accumulated in. One ent dr told me it looked like i had something called a thornwall (sp?) cycst, he said maybe accumulated there. (A small pocket in the nasal area, can look it up) It shows in x-ray, but I couldn't tell if the location was quite where I sense it to be, just as you described. Gargling does help it, other times it loosen without warning. sometimes when talking, i also have it happen while eating. Yuck. I always keep napkin/tissue near by. I've learned to live with it, although can't stand it. but would be great if anyone ever figured it out for sure! I think it may be like you said, some people have this area it gets stuck, others don't. Or if some others do, they don't happen to create as much nasal drainage. It seems combination of extra more frequent drainage and a place it gets built up. Excellent description you gave!

REPLY
@jea1

Reply to pokee : you wrote the most accurate description I've seen. It does feel just as you describe. I too sense there is a spot, crevice that it accumulated in. One ent dr told me it looked like i had something called a thornwall (sp?) cycst, he said maybe accumulated there. (A small pocket in the nasal area, can look it up) It shows in x-ray, but I couldn't tell if the location was quite where I sense it to be, just as you described. Gargling does help it, other times it loosen without warning. sometimes when talking, i also have it happen while eating. Yuck. I always keep napkin/tissue near by. I've learned to live with it, although can't stand it. but would be great if anyone ever figured it out for sure! I think it may be like you said, some people have this area it gets stuck, others don't. Or if some others do, they don't happen to create as much nasal drainage. It seems combination of extra more frequent drainage and a place it gets built up. Excellent description you gave!

Jump to this post

@jea1 Yeah, I used to have that many times per day. Then a doc decided he should find out, so he wanted to cut off a sort of cyst or macular skin from my larynx. Then I learned I have Barrett's Esophagus (genetic), which should not have cause the growth on the larynx. We decided not to operate on the Barrett's, and the surgery on the voice box seemed more urgent, and turned out to be Amyloid on the larynx, as well as the Barrett's. Then Mayo took out most of my Thyroid, so I started taking levothyroxine. Anyway, nothing is simple any more. The Barrett's is still growing, but I should be dead before too many more years, anyway. I am 81, with several fatal diseases.

REPLY

I haven’t had any improvements with my nasal scabs. I posted here back in 2019. It looks like people have had some success with regularly blasting their noses full of saline solution. Will try that and report back.

REPLY

Navage 1-2 times daily and a nasal emollient daily - Ponaris is what I use. It's a question of maintenance forever I'm afraid, if you suffer from it. Totally worth the effort/cost though. I used to live in fear of one of those things dislodging in front of other people!!

REPLY
Please sign in or register to post a reply.