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Blood tinged saliva stains, odd breath smell. Source?

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My son is 18 months old and has recently woken a few times with blood tinted saliva stains on his sheets. Almost a brownish red color. He is eating and drinking normal but I have noticed a bit of post nasal drip and an on and off odd smell on his breath. He seems perfectly fine otherwise. I am terrified as I am not able to find a source in his mouth.

Category: Pediatrician

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Category: ICU/ Critical Care Specialist
 28 Doctors Online

Dear parent,
Thank you for your query at
I can understand your concerns. It must be really disturbing to find blood stained saliva.
The most common cause is due to the child biting tongue or lips during sleep. But, the fact that there are no injury marks on his lips or tongue obviously rules out that cause. Secondly, the source can be internal stomach bleeding. But, before thinking about internal bleeding, we obviously need to rule out basic mimics. Chocolates or other foods such as brownies or cakes can stay back in the child's mouth and present like this.
If it is indeed internal bleeding, child would need to be examined in detail by a paediatrician. We need to check for any bluish bleeding spots under his skin. We need to check for enlargement of his liver and spleen. We also need to get a few blood tests such as platelet count and coagulation profile done.
Hoping it is not actually internal bleeding.

Dr. Saptharishi

Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

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