Cough is one of the most common presenting symptom in primary practice. Subacute cough is defined as cough persisting for 3-8 weeks, and chronic cough as that persisting for more than 8 weeks in adults. Chronic cough in children has been defined as the presence of cough every day for 4 weeks or more. Subacute cough is most often self-limited, but chronic cough may provide significant challenges for effective evaluation and management. The difficulty is in determining the cause of cough, because some "etiologies" are syndromes without accurate diagnostic tests. The cause is determined instead by typical historical features, elimination of alternative causes, and response to targeted therapies (therapeutic trials serve as tests). Nonetheless, a careful history and examination, followed by carefully selected therapeutic trials and/or diagnostic evaluations, may satisfactorily resolve cough in over 90% of cases.
However for children aged ≤14 years, common causes of chronic cough may be different to those in adults; the child’s age, cough characteristics, clinical history and geographical setting should be taken into account. Detailed recommendations regarding diagnostic algorithms and therapeutic trials for children may also differ from those for adults.
Nontargeted cough suppressant therapy is rarely effective for chronic cough.
- Lung cancer
- Bronchiectasis and chronic suppurative lung disease
- Interstitial pulmonary fibrosis
- Tuberculosis (TB)
- Recurrent aspiration
- Zenker diverticulum
- Thoracic aortic aneurysm (TAA)
- Foreign body
- Hypersensitivity pneumonitis
- Tropical filarial pulmonary eosinophilia
- Somatic cough syndrome (psychogenic cough)
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