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Respiratory Disorders (Expert Forum)
Pus in sputum but no infection?
Answered by
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Pus in sputum but no infection?
by Gilbert1, Dec 20, 2004 12:00AM
Hello.
I am a 25 year old female with severe brittle asthma and CVID (a primary immunodeficiency), only diagnosed after finding early signs of bronchiectasis on my CT scan. I am now receiving IVIG to treat the immune problem, and I am on continuous antibiotics to try and limit the number of infections I get. Because I am dependent on high doses of oral steroids to stabilise my asthma, serious infections have been a severe problem in the past.
I send sputum samples into the hospital once a month to try and detect any bugs as soon as they start. Recently all the samples have been negative, which obviously I am very pleased about. However, they do all record 'Mucus and pus'. Why would my sputum contain pus if there is no infection? Does this mean that further damage is continuing?
I have previously suffered from MRSA several times, as well as the more usual bacterial infections, viruses and aspergillus.
Many thanks for your help.
I am a 25 year old female with severe brittle asthma and CVID (a primary immunodeficiency), only diagnosed after finding early signs of bronchiectasis on my CT scan. I am now receiving IVIG to treat the immune problem, and I am on continuous antibiotics to try and limit the number of infections I get. Because I am dependent on high doses of oral steroids to stabilise my asthma, serious infections have been a severe problem in the past.
I send sputum samples into the hospital once a month to try and detect any bugs as soon as they start. Recently all the samples have been negative, which obviously I am very pleased about. However, they do all record 'Mucus and pus'. Why would my sputum contain pus if there is no infection? Does this mean that further damage is continuing?
I have previously suffered from MRSA several times, as well as the more usual bacterial infections, viruses and aspergillus.
Many thanks for your help.
Doctor's Answer
by National Jewish, Dec 31, 2004 12:00AM
, Dec 31, 2004 12:00AM
Pus means containing lots of white blood cells. As the word is commonly understood this is generally an indicator of infection. Perhaps the culture reports are misleading because:
· the specimens are not being handled or processed appropriately and/or in a timely fashion so that the bacteria are dead on arrival in the culture media or;
· they are not using the culture media or techniques necessary to grow or demonstrate the infectious organisms in your sputum.
With asthma the basic problem is chronic inflammation along with tightening of the smooth muscles that surround the airways of the lungs. This inflammation is decreased and prevented when an inhaled steroid is used daily. Bronchospasm is the tightening of the smooth muscles that surround the airways of the lungs. A fast-acting inhaled bronchodilator medicine, like albuterol, reverses the bronchospasm quickly by relaxing the smooth muscles. It is most important that the inflammation and your asthma be under good control. If you need to use a fast-acting inhaled bronchodilator medicine more than twice in a week this means that the inflammation and your asthma are not controlled. When a long-lasting inhaled bronchodilator medicine is used every day it prevents bronchospasm. This would have the added benefit of decreasing the need for the fast-acting inhaled bronchodilator medicine. Your doctor may recommend taking a higher dose of the inhaled steroid. There is much less risk of side effects from an inhaled steroid, so this is a good option instead of taking high doses of oral steroids.
When this inflammation is not controlled, it increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people infections cause more asthma symptoms, but for other people allergies do not cause asthma symptoms at all.
With common variable immune deficiency (CVID) your immunoglobulin G (IgG) is low. IgG is a part of your immune system that helps you to fight infections. When the IgG level in your blood is low it can be harder for you to fight infections. Recurring infections are the most common problem with CVID. These commonly include sinus and chest infections. Replacement therapy with intravenous immunoglobulin (IVIG) is the treatment for CVID. This will raise your IgG levels so that you can fight infections better. Please read our Immune Deficiencies MedFact at http://www.nationaljewish.org/medfacts/immune.html for more information.
Inflammation causes damage to the airways of the lungs. When the airways become dilated this is called bronchiolectasis. When the airways become distorted with areas where mucus can collect this is called bronchiectasis. Usually these changes can be seen with a CT scan of the lungs. It can be difficult to clear this mucus because of damage to the normal methods that the lungs use to clear mucus. This can lead to episodes of infection. Typically an ongoing infection can lead to inflammation. So it is important that lung infections are treated. Pulmonary hygiene is very important in preventing and controlling lung infections. Using an inhaled bronchodilator may help to loosen the mucus. Many people find the routine use of a mucus clearance device to be very helpful in clearing the mucus from their lungs. This is a small device that you exhale into causing a vibration in your lungs that loosens mucus so that you can cough it up easier. The names of 2 types of devices are Acapella and Flutter Valve. Bronchiectasis can result from airway blockage along with infection, so it may effect only one area of your lung. If your recurrent lung infections are always in the same area of the lung, surgery to remove that portion of your lung may provide a cure.
· the specimens are not being handled or processed appropriately and/or in a timely fashion so that the bacteria are dead on arrival in the culture media or;
· they are not using the culture media or techniques necessary to grow or demonstrate the infectious organisms in your sputum.
With asthma the basic problem is chronic inflammation along with tightening of the smooth muscles that surround the airways of the lungs. This inflammation is decreased and prevented when an inhaled steroid is used daily. Bronchospasm is the tightening of the smooth muscles that surround the airways of the lungs. A fast-acting inhaled bronchodilator medicine, like albuterol, reverses the bronchospasm quickly by relaxing the smooth muscles. It is most important that the inflammation and your asthma be under good control. If you need to use a fast-acting inhaled bronchodilator medicine more than twice in a week this means that the inflammation and your asthma are not controlled. When a long-lasting inhaled bronchodilator medicine is used every day it prevents bronchospasm. This would have the added benefit of decreasing the need for the fast-acting inhaled bronchodilator medicine. Your doctor may recommend taking a higher dose of the inhaled steroid. There is much less risk of side effects from an inhaled steroid, so this is a good option instead of taking high doses of oral steroids.
When this inflammation is not controlled, it increases the sensitivity of the airways to a variety of things that make asthma worse. These asthma triggers vary from person to person. For some people infections cause more asthma symptoms, but for other people allergies do not cause asthma symptoms at all.
With common variable immune deficiency (CVID) your immunoglobulin G (IgG) is low. IgG is a part of your immune system that helps you to fight infections. When the IgG level in your blood is low it can be harder for you to fight infections. Recurring infections are the most common problem with CVID. These commonly include sinus and chest infections. Replacement therapy with intravenous immunoglobulin (IVIG) is the treatment for CVID. This will raise your IgG levels so that you can fight infections better. Please read our Immune Deficiencies MedFact at http://www.nationaljewish.org/medfacts/immune.html for more information.
Inflammation causes damage to the airways of the lungs. When the airways become dilated this is called bronchiolectasis. When the airways become distorted with areas where mucus can collect this is called bronchiectasis. Usually these changes can be seen with a CT scan of the lungs. It can be difficult to clear this mucus because of damage to the normal methods that the lungs use to clear mucus. This can lead to episodes of infection. Typically an ongoing infection can lead to inflammation. So it is important that lung infections are treated. Pulmonary hygiene is very important in preventing and controlling lung infections. Using an inhaled bronchodilator may help to loosen the mucus. Many people find the routine use of a mucus clearance device to be very helpful in clearing the mucus from their lungs. This is a small device that you exhale into causing a vibration in your lungs that loosens mucus so that you can cough it up easier. The names of 2 types of devices are Acapella and Flutter Valve. Bronchiectasis can result from airway blockage along with infection, so it may effect only one area of your lung. If your recurrent lung infections are always in the same area of the lung, surgery to remove that portion of your lung may provide a cure.
