Pulmonology Book

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Chronic Cough in ChildrenAka: Pediatric Chronic Cough

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  1. Causes: Common etiologies
    1. See Chronic Cough Causes in Children
    2. Reactive airway disease or Bronchospastic condition
      1. Occurs in 70% of children at some time
      2. Worse at night and with Exercise
    3. Post-Viral inflammation (Post-bronchitic cough)
      1. Persists 3 weeks after Upper Respiratory Infection
    4. Allergic Rhinitis
      1. Consider Allergy Testing
    5. Acute Sinusitis
      1. Rhinorrhea for 2 weeks is Sinusitis in 70-85% cases
      2. Eye mattering may be associated
  2. Evaluation
    1. See Chronic Cough Evaluation in Children
  3. Management: First stage
    1. Upper airway
      1. Consider empiric Sinusitis antibiotic treatment
      2. Consider trial of Antihistamine and Decongestant
      3. Use inhaled nasal steroids if practical
      4. Environmental control in child's bedroom
        1. See Environmental Allergan
    2. Lower airway
      1. Consider trial of inhaled Bronchodilators
      2. Consider trial of Inhaled Corticosteroids
      3. Prednisone short course occasionally may be helpful
  4. Management: Next Stage (If failure of first stage)
    1. Re-evaluation
      1. Cystic Fibrosis
      2. Asthma
      3. Gastroesophageal Reflux
      4. Congenital anomaly
    2. Intensify Asthma therapy
    3. Do not suppress the cough

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