II. Causes: Common (represents 90% of Chronic Cough Causes)

  1. Upper Airway Cough Syndrome or post nasal drainage (40%)
    1. Sinusitis
    2. Allergic Rhinitis
  2. Asthma (24%)
  3. Gastroesophageal Reflux (15%)
  4. Bronchitis or post-Bronchitic Cough (11%)
  5. Chronic Bronchitis
  6. Tobacco abuse
  7. Transient airway hyperresponsiveness
    1. Post-viral cough
    2. Post-Bronchitic cough
    3. Bordetella pertussis infection
      1. Pertussis is responsible for 20% of severe cough in adults and teens >2 weeks presenting to ED
  8. Medication related
    1. ACE Inhibitors (5-20% of patients)
    2. Beta Blockers (less common)

III. Causes: Less Common Causes of Chronic Cough

  1. Congestive Heart Failure
  2. Cancer
    1. Bronchogenic Carcinoma
    2. Esophageal Cancer
  3. Lung disease
    1. Emphysema
    2. Sarcoidosis
    3. Bronchiectasis (4%)
    4. Eosinophilic Bronchitis
    5. Tuberculosis
    6. Fungal Lung Infection
    7. Cystic Fibrosis
  4. Recurrent Aspiration
    1. Post-Cerebrovascular Accident
    2. Frequent Vomiting
    3. Alcoholism
  5. Pressure from an intrathoracic mass
    1. Thoracic aneurysm
    2. Thyromegaly
    3. Mediastinal Lymphadenopathy
  6. Irritation of cough receptors in ear
    1. Impacted cerumen or hair in ear canal
    2. Hair
    3. Ear Foreign Body in external auditory canal
  7. Miscellaneous causes
    1. Opportunistic infections (immunocompromised patient)
    2. Lymphangitis carcinomatosis
    3. Foreign body
    4. Chronic occupational inhalation Bronchial irritants
    5. Psychogenic cough (Habit Cough)
    6. Arteriovenous malformation

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