coughing orange mucus

[amandabrawner]

I went to the E.R. last night for difficulty breathing. I was told that I have Acute Bronchitis. I am on a steroid and antibiotics. No problem there, I have had bronchitis several times. What concerns me is that a few days ago I was coughing up pink mucus. Then it turned into a peach color, now it is getting brighter with orange. Now, I did go to grade school so I am thinking yellow + red = orange. I asked the Dr. at the E.R. he didn't seem to have an answer for me and was not concerned about this. Why is my mucus a solid orange mass that I am coughing up? No, I have not eaten or drank anything that was orange or pink.

[National Jewish Health]

There is very little written in the medical literature about sputum color.  The distinctions commonly made are on the basis of clear or opaque vs discolored, yellow and green usually indicative of bacterial infection.  In the following abstract, note the reference to "rust" colored sputum.  Multiple factors can determine color including bacterial species, length of time in the bronchi before expectoration, pH of bronchial secretions, pattern of white blood cell response, presence or absence of bleeding.
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Authors
Full Name Johnson, Allen L. Hampson, David F. Hampson, Neil B.
Institution The Polyclinic, Seattle, WA, USA.
Title Sputum color: potential implications for clinical practice.
Source Respiratory Care. 53(4):450-4, 2008 Apr.
Abstract
BACKGROUND: Respiratory infections with sputum production are a major reason for physician visits, diagnostic testing, and antibiotic prescription in the United States. We sought to determine whether the simple characteristic of sputum color provides information that impacts resource utilization such as laboratory testing and prescription of antibiotics.
METHODS: Out-patient sputum samples submitted to the microbiology laboratory for routine analysis were assigned to one of 8 color categories (green, yellow-green, rust, yellow, red, cream, white, and clear), based on a key made from paint chip color samples. Subsequent Gram stain and culture results were compared to sputum color.
RESULTS: Of 289 consecutive samples, 144 (50%) met standard Gram-stain criteria for being acceptable lower-respiratory-tract specimens. In the acceptable Gram-stain group, 60 samples had a predominant organism on Gram stain, and the culture yielded a consistent result in 42 samples (15% of the 289 total specimens). Yield at each level of analysis differed greatly by color. The yield from sputum colors green, yellow-green, yellow, and rust was much higher than the yield from cream, white, or clear.
CONCLUSIONS: If out-patient sputum is cream, white, or clear, the yield from bacteriologic analysis is extremely low. This information can reduce laboratory processing costs and help minimize unnecessary antibiotic prescription.
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Color is not diagnostic.  Sputum culture is diagnostic and can be the basis of antibiotic selection.  It is thus, much more important.

Blood-tinged mucus is very common with a variety of infections.  If combined with what would otherwise be yellow sputum it could present as orange sputum.  Bloody sputum or pure blood is not.  If not cleared from the lungs quickly, blood could conceivably be orangish rather than bright red.

The presence of a little blood in sputum, especially with harsh coughing, is not a cause for alarm.

An abnormal chest x-ray and/or persistence of blood in the sputum after infection has resolved would be a strong indication for further diagnostic procedures, including bronchoscopy.