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Causes of Recurrent/Persistent Cough - Coggle Diagram
Causes of Recurrent/Persistent Cough
URTIs
usually viral
can appear persistent due to getting a series of them
mycoplasma
pertussis
RSV
possibly unresolved lobar collapse after acute infection
Asthma
a/w wheeze + SOB
Suppurative lung disease
CF
primary ciliary dyskinesia
congenital abnormality of structure/function of cilia
impaired mucociliary clearance
productive cough (many children swallow sputum so important to listen to quality of cough, 'wet')
purulent nasal discharge
chronic ear infections
50% have dextrocardia + situs inversus (Kartagener syndrome)
immune deficiency
primary
secondary e.g. chemo
bronchiectasis
best identified on chest CT
Recurrent aspiration
GORD
swallowing disorders - oropharyngeal incoordination (e.g. CP)
Persistent endobronchial infection
chronic wet cough
occasionally long term prophylactic antibiotics needed
Inhaled foreign body
do CXR + bronchoscopy
hyperlucency of right lung + mediastinal shift to left
if airway obstructed do back blows + thrusts, open airway + start CPR if unconscious, encourage cough if possible
Smoking
active (older children smoke)
passive (significance of parental smoking underestimated)
TB
do CXR + tuberculin Mantoux skin test
hilar/paratracheal lymphadenopathy
Habit cough
no organic cause
can be remedied in most children with simple behavioural therapy
repetitive coughing up to several times per min for extended periods, even all day
total absence of coughing during sleep / when child distracted
aka “psychogenic” cough
usually begins after URTI but the persists long after the other resp sx resolve
harsh, barking, nonproductive
not exacerbated by physical exercise
many misdxed with asthma
may be a/w psychosocial stressors, school absenteeism
some also have anxiety disorders + conversion disorder
Airway anomalies
tracheo-bronchomalacia
TOF
