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The most important signs are fever, low body temperature, new purulent sputum, and hypoxemia (decreasing amounts of oxygen in the blood).
Cough can be productive with foul smelling purulent sputum ( 70%) or less frequently with blood (i.e. hemoptysis in one third cases).
On arrival she complained of cough with purulent sputum, haemoptysis, and pain in the right side of the chest in addition to her asthmatic symptoms.
Purulent Sputum contains pus, composed of white blood cells, cellular debris, dead tissue, serous fluid and viscous liquid (mucus).
Antibiotics are indicated when a patient notes increased sputum production, purulent sputum, increased dyspnea, has an elevated white count, or is febrile.
Persons with pneumonias caused by Streptococcus pneumoniae and Haemophilus species characteristically have an acute onset (3--5 days) of symptoms, including fevers, chills, rigors, chest pain, cough productive of purulent sputum, and dyspnea (92).
But Tashkin and his fellow study investigators did show that adding Spiriva to different classes of respiratory medications improved lung function, bettered quality of life, and cut the number of disease exacerbations (three days or more of coughing, purulent sputum, wheezing, and/or shortness of breath requiring antibiotic or steroid treatment).