Chronic cough in children

Chronic cough in children

Ghamartaj Khanbabaee,Seyed Ahmad Tabatabaii1, ,Saeed Sadr

,Nazanin Farahbakhsh

Abstract:

An effective cough is essential for maintaining respiratory health. Cough is the most common reason why patients acutely seek medical consult in countries. There are many causes of cough; the majority originates in the lungs but there are also nonpulmonary etiologies such as cardiac problems, ear disease, medications.

Materials and methods: Chronic cough in children 14 years and younger usually is defined as a daily cough lasting four or more weeks. The British Thoracic Society (BTS) utilizes a threshold of eight weeks duration.However, the guideline also encourages individualized management. Specific cough refers to a chronic cough that is ultimately attributable to an underlying physiologic cause (which is usually but not always of pulmonary origin).  Conversely, a “nonspecific” cough is defined as a chronic cough that does not have an identifiable cause, after a reasonable evaluation. A chronic cough is more likely to be nonspecific if it is dry and there are no abnormalities identified on initial evaluation

Findings: The systematic evaluation of a child with chronic cough starts with a targeted detailed history, physical examination, chest radiograph, and (if the child is able) spirometry. The information obtained is then used to categorize the cough as specific (ie, underlying disease likely present) or nonspecific (no evidence of an underlying disease, so the cough is more likely to resolve spontaneously). However, this initial evaluation does not definitively distinguish specific cough from nonspecific cough. Therefore, a provisional diagnosis can be made, but ongoing evaluation is required and the final diagnosis depends upon the clinical course.

Conclusion: All children with chronic cough should be systematically evaluated including a detailed targeted history, physical examination, chest radiograph, and spirometry (when possible). It is recommend NOT treating chronic cough with over-the-counter cough suppressants or other nonprescription cough medicines.

Key words: chronic cough, children, specific cough