Evaluation of chronic cough in children: a practical approach

ABSTRACT

Cough is one of the main causes of seeking medical care worldwide. Cough that persists for more than a few weeks is very tasking to the patient and family, both financially and psychosocially. The latter is particularly notable when cough is chronic (> 8 weeks) and the patient is a child.

Whereas acute cough in children is mostly caused by an infection, chronic cough can have numerous respiratory tract and extra-respiratory causes and mechanisms. An early recognition of the underlying cause would lead to early and precise treatment that, in some cases, may require multiple medical consults. Towards such an objective, this article is designed to provide a practical, easy-to-follow guideline for evaluating chronic cough in children.

A skillful medical history-taking of the present illness, past history, family history, and environmental history, followed with a comprehensive physical examination can provide very valuable clues for selecting supportive, cost-effective investigative tests. In addition to the currently available standard evaluation tests, technological advances are leading to the recent development of practical devices for objective assessment of cough characteristics which in turn enhance precise evaluation.

IMPACT STATEMENT

This article provides an easy-to-follow practical approach for evaluation of chronic cough in children. It should facilitate early identification of the underlying cause, prescribing the appropriate management, and limiting the illness’ negative impact.

KEY WORDS

Childhood chronic cough; chronic cough causes; cough characteristics; radiologic findings in cough; cough assessment devices.