- Cough is an important defense mechanism of the lungs and is a common symptom.In most
patients, it is self-limited. However, cough can be ominous, indicating serious underlying disease - A history of accompanying signs or symptoms, whether localized to the respiratory tract (wheeze, stridor) or elsewhere (failure to thrive, frequent malodorous stools) can give important clues
- Infections are the most common cause of acute cough in all age groups and are responsible for some chronic coughs. The age of the patient has a large impact on the type of infection
- Infants
Viral upper respiratory infections (common cold); croup (laryngotracheobronchitis);viral bronchiolitis, particularly with RSV; and viral pneumonia are the most frequently encountered respiratory
tract infections and hence the most common causes of cough in infancy. Viral illness may predispose to bacterial superinfection (croup and Staphylococcus aureus tracheitis or influenza and
H. influenzae pneumonia). - In early childhood, as children attend day care and nursery schools, they are constantly exposed to respiratory viruses to which they have little or no immunity (e.g., rhinoviruses, adenoviruses, parainfluenza,
and coxsackievirus). Such children may have as many as 6 to 8 or even more colds in a year. - Red Flags and When to Refer
- If associated with severe, acute
Hemoptysis
Dyspnea
Hypoxemia
If associated with chronic
Failure to thrive
Steatorrhea
Decreased exercise tolerance
Digital clubbing
Persistence of Cough for 2 weeks or more
Radiographic abnormality, especially if asymmetric
Failure to respond to empirical therapy
Antibiotics for presumed infection
Bronchodilators for presumed reactive airways
Dr. Jayaprakash
Superintendent, ICH.
Institute of Child Health.
Gov. Medical College Kottayam.
Kerala, India.