expert needed

[uncut32324]

dear doc ..im 29 y old male. non smoker
i was with friends two weeks ago and smoked Hooka for a lil bit .
a cough started  but very mild 2 weeks  ago but very mild
last week on wednsdsay started to get worse with sputum . sometimes white soem times small pecies of yellow - green sputum i  can see
last wednsday though and specially thursday the cough was veeeety sever i couldnt sleep . so i went to the bathroom and tried to force clearing the sputum. ..so i vomited alot trying to force it .
i washed my mouth and went to sleep . i woke up the next day morning i found blood mixed with my sputum in the morning then it cleared ..i went to the doc ...took x-ray gave me Ab and said to go home
6 days now ....almost no cough and clear sputum the whole day ..only when i wake up there is blood with the first sputum and few followin it then it clears to white for the whole day .

is it normal blood for 6 days for irritaion after forcful clearing sputum from. ( where i vomited after)
should i be worried ? should i ask for a CT Scan ?

[uncut32324]

thanks for the answer doc
i somke hooka maybe once a year at most
im a passive smoker ..almost everyone around me smokes

i still have cough here an there . but much better than before
my sputum almost always white
but sometimes 2 times or few yellow in color
streaks of blood when i wake up from sleep

my direct Qs are if the bloood ia from harsness of cough or inflamation how long can it stays
is normal more than 6 days ?

should i go tmr to an ENT doc and see another x ray tmr for chest ?
its been a week since my last x ray
if i was ur pt would u order a CT ?

[David Tinkelman, M.D.]

I suspect that the Hooka or the water was contaminated with bacteria or some other infectious agent.  Either that or your airways are very sensitive to the smoke.  To have coughed-up blood in this circumstance is a bit unusual but not worrisome.  It may have been associated with the harshness of your cough rather than the severity of bronchial inflammation, or both.

In any event, either the antibiotic and/or the working of your immune system, with the passage of time, has resulted in what, by your description, appears to be near complete resolution.

At your age, as a non-smoker, the odds are highly in your favor, for having nothing to worry about.  The only caveat would be that if the blood persists, especially when all other symptoms have subsided for another ten days, you should have further evaluation of both upper and lower airways.  That is direct examination of the former, upper airways, by an ENT specialist and of the lower airways (your lungs) with another X-ray in 1-2 months.

I am pleased to learn that you are a non-smoker and hope that behavior persists for the rest of your (long) life.  As for the Hooka, you might want to avoid it altogether either indefinitely or for a minimum of 6 months.  You might also inquire of others who smoked with you that night, if any of them experienced the same symptoms, even if not as severe.  If the answer is yes, you should notify the owner of the Hooka.

Good luck