After anti-inflammatory treatment of pulmonary patchy shadow, coughing rust-colored sputum with chest pain may be due to the lesion in the active stage is still aggravated, the recurrence of infection and other reasons. 1. The lesion is in the active stage: after anti-inflammatory treatment, coughing rust-colored sputum with chest pain, this symptom is a typical sign of Streptococcus pneumoniae infection, this symptom suggests that the lesion is in the active stage or the disease is still aggravating, the Streptococcus pneumoniae bacteria in this period of time will lead to congestion and edema of the lung tissues, the alveolar red blood cells are phagocytosis, destruction of sputum coughed up with the sputum, the appearance of rust-colored sputum. 2. Disease relapse: Patients who still have the symptom of coughing up rust-colored sputum after anti-inflammatory treatment may also have a relapse of the disease. Chest pain may be due to pleurisy, pleural adhesions and chest pain. Coughing up rust-colored sputum with chest pain after anti-inflammatory treatment of chest plaque may also have other causes, and should be promptly consulted for a clear diagnosis and symptomatic treatment.