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Here: an overview of the pathophysiology of chronic cough, its epidemiology and etiology; the clinical evaluation, diagnostic workup, and a summary of treatment options.
Chronic cough in children presents some unique challenges. Many adult diagnoses, such as COPD and chronic bronchitis, are not recognized entities in the pediatric literature. The underlying diagnosis can therefore be difficult to determine.
Understandably, long-standing cough is stressful for the family and patient. Families may seek multiple medical consultations in quest of symptom resolution. In a study of 190 children, in a 12-month period, more than 80% had more than 1 doctor visits and more than 50% had more than 10 doctor visits for chronic cough.1 Clinical studies found 2 major fears expressed by mothers were that their child was going to die as a result of choking on phlegm or vomit or of an asthma attack or cot death and that their child would have long-term chest damage as a result of ongoing cough. Mothers reported disturbed sleep because of their fears.2
In this article, I present an overview of the pathophysiology of chronic cough and its epidemiology and etiology. I also offer helpful tips for the clinical evaluation and diagnostic workup, a tip sheet for assessing the evidence for underlying disease, and a summary of treatment options.
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1. Marchant JM, Newcombe PA, Juniper EF, et al. What is the burden of chronic cough for families? Chest. 2008;134:303-309.
2. Cornford CS, Morgan M, Ridsdale L. Why do mothers consult when their children cough? Fam Pract. 1993;10:193-196.