[Chronic cough in children--what to consider and how to evaluate?].
There is a long list of differential diagnoses for chronic cough lasting longer than 4 weeks in children. Diagnostic work up starts with a detailed history taking and a clinical investigation followed by a chest X-ray (in one plane) and a spirometry. For the latter reliable results can be achieved by children older then 5 years. If the diagnostic work up is still inconclusive and if the child is in good clinical condition, a 4 weeks' course of inhalation therapy with steroids and betamimetics together with a 2 weeks' course of antibiotics with a macrolide is warranted. In case coughing persists a thorough diagnostic work up is indicated to rule out conditions like cystic fibrosis, relevant humoral immuno-deficiencies, primary ciliary dyskinesia, anatomic malformation or chronic pulmonary aspiration, preferably done by a pediatric pulmonologist. Chronic cough has to be considered abnormal in any child under the age of 1 year. For this age group a final diagnosis is of special importance.
Iseli
P
P
Kinderspital Chur. Peter.Iseli@ksgr.ch
D000293:Adolescent; D000367:Age Factors; D000465:Algorithms; D000996:Antitussive Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis*; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003371:Cough / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008487:Medical History Taking; D013902:Radiography, Thoracic; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000996:Antitussive Agents