Chronic Cough

Differential diagnosis

  • Infection (virus, bacteria, pertussis, TB)
  • Reactive airway disease (asthma)
  • Reflux disease
  • Post nasal drip, rhinitis/sinusitis
  • Psychogenic (habit)
  • Foreign body
  • Congenital abnormality
  • Neoplasm
  • Aspiration, CF (respiratory findings, pancreatic insufficiency)
  • Metabolic

History

  • Onset, frequency, timing (at night), quality (barking)
  • Productive, hemoptysis
  • Precipitating factors, triggers (exercise, pets, smoking, mealtime)
  • Dysphagia
  • Sick contacts
  • Tics
  • Past medical surgery, surgeries, medications, allergies

* Psychogenic cough – does not occur when distracted, does not occur during sleep, child may have other habits (eyes, shoulder shrugs, throat clearing)

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