Coughing up thick green sputum is usually seen to be caused by purulent bacterial infections. More common is Pseudomonas aeruginosa infection, where the sputum coughed up has a sweet smell. Possible clinical respiratory diseases include bronchitis, pneumonia, lung abscess, or even bronchiectasis combined with a serious infection. You can choose to take X-ray and CT of both lungs, and you can also take green pus sputum for pathogen culture and drug sensitivity test to select sensitive antibiotics for treatment. For example, ceftazidime, tobramycin, levofloxacin and other drugs can be chosen, and if necessary, more than two kinds of antibiotics can be combined for treatment.