What Does It Mean When Children Cough up Sulfur Granules?

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Ask the experts

My granddaughter - a twin whose birth weight was less than 2 lbs. - is now a healthy four year old.  In the past few weeks, she has been coughing up (deep, hard hacking) small pieces of tissue. Analysis shows them to be sulphur granules mixed with a bacteria colony. X-rays and CT scan show nothing. Her pediatrician appears to know nothing about this. He will consult with a pulmonary specialist - so I presume he thinks it may be lung related. (Both girls have mild asthma and various allergies). The pediatrician's only comment was that he needed to find out where these things were coming from. My daughter and I would really appreciate it if you would share any knowledge you may have concerning this.

Doctor's response

Consultation with a pulmonary specialist is a good idea. Sulphur granules are seen in association with certain microorganisms (typically Actinomyces), that can be identified with specific laboratory techniques. If identified effective treatment is available for this infection.

Occasionally sulphur granules can be mistaken for mucus changes sometimes seen in asthmatics. Your granddaughter's pediatrician appears to be following up on this problem appropriately.

Medical Author: Alan Szeftel, M.D.

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Reviewed on 1/11/2018
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