Chronic cough is probably the commonest cause of referral to my clinic. Although frequently troublesome for prolonged periods most cases, fortunately turn out to have a bening cause; prolonged viral infections as well as recurrent viral infections. Some children can have from a few to 10 to 12 such infections in any one of their first few years of life. If these ocurr close together it can give the worrying impression that the child is suffering from one continuous episode.
Other causes would need to be considered and excluded. For asthma, see cough variant asthma under page for asthma. Tuberculosis would normally affect relevant predisposed individuals including immunocompromised patients and those from ethnic minorities; it can ocurr rarely in otherwise 'healthy' individuals. Prolonged bacterial bronchitis is probably more common than appreciated and sometimes requires unusually long courses of antibiotics to treat. Cystic fibrosis would need to be considered in children with chronic cough especially if there is any failure to thrive. For recurrent proven pneumonia in early childhood investigations into possible immune defiency would need to be considered. Gastro-esophageal reflux disease tends to be a problem of early infancy, but can be a co-factor in excaerbations of cough caused by other causes in older children.Other causes include psychogenic (habitual) cough, sinusitis, foreign bodies, growing lesions in the respiratory tract (extremely rare).
Most children would not need more than a simple assessment including a chest X ray and a few blood tests to confirm the diagnosis in the majority of cases.
Child witrh tuberculosis