title: CICADA: Cough in Children and Adults: Diagnosis and Assessment. Australian cough guidelines summary statement.
abstract: Cough is a common and distressing symptom that results in significant health care costs from medical consultations and medication use. Cough is a reflex activity with elements of voluntary control that forms part of the somatosensory system involving visceral sensation, a reflex motor response and associated behavioural responses. At the initial assessment for chronic cough, the clinician should elicit any alarm symptoms that might indicate a serious underlying disease and identify whether there is a specific disease present that is associated with chronic cough. If the examination, chest x-ray and spirometry are normal, the most common diagnoses in ADULTS are asthma, rhinitis or gastro-oesophageal reflux disease (GORD). The most common diagnoses in CHILDREN are asthma and protracted bronchitis. Management of chronic cough involves addressing the common issues of environmental exposures and patient or parental concerns, then instituting specific therapy. In ADULTS, conditions that are associated with removable causes or respond well to specific treatment include protracted bacterial bronchitis, angiotensin-converting enzyme inhibitor use, asthma, GORD, obstructive sleep apnoea and eosinophilic bronchitis. In CHILDREN, diagnoses that are associated with removable causes or respond well to treatment are exposure to environmental tobacco smoke, protracted bronchitis, asthma, motor tic, habit and psychogenic cough. In ADULTS, refractory cough that persists after therapy is managed by empirical inhaled corticosteroid therapy and speech pathology techniques.
authors.affiliation: Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia. peter.gibson@hnehealth.nsw.gov.au
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gibson
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Glasgow
authors.forename: Peter W
authors.initials: PW
authors.lastname: Holmes
authors.forename: Peter
authors.initials: P
authors.lastname: Katelaris
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kemp
authors.forename: Louis I
authors.initials: LI
authors.lastname: Landau
authors.forename: Stuart
authors.initials: S
authors.lastname: Mazzone
authors.forename: Peter
authors.initials: P
authors.lastname: Newcombe
authors.forename: Peter
authors.initials: P
authors.lastname: Van Asperen
authors.forename: Anne E
authors.initials: AE
authors.lastname: Vertigan
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology; D001315:Australia; D002648:Child; D002908:Chronic Disease; D003371:Cough / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution