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[Definition and nosological aspects of chronic cough in children]
1Unité de pneumologie-allergologie, hôpital des Enfants, 330, avenue de Grande-Bretagne, BP 3119, 31026 Toulouse, France. bremont.f@chu-toulouse.fr
Insights
Chronic cough, lasting over three weeks, requires clinical analysis for diagnosis and treatment. Recognizing cough variants like asthma is key, and empiric bronchodilator treatment is recommended for persistent dry nocturnal cough.
Area of Science:
- Pulmonology
- Pediatrics
- Clinical Medicine
Context:
- Cough is a physiological reflex with 'chronic cough' defined as lasting at least 3 weeks.
- Clinical analysis of patient characteristics is crucial for accurate diagnosis and effective treatment.
- Key clinical aspects include cough in young children (<3 years), nocturnal cough, and productive cough.
Purpose:
- To outline the diagnostic and treatment approach for chronic cough based on clinical characteristics.
- To highlight the significance of recognizing cough as a symptom of 'variant asthma' across all age groups.
- To provide a treatment recommendation for persistent dry nocturnal cough.
Summary:
- Chronic cough, persisting for over 3 weeks, necessitates a thorough clinical evaluation.
- Specific patient profiles, such as young children, nocturnal cough, and productive cough, guide diagnosis.
- 'Variant asthma' cough is a common, often overlooked, cause of chronic cough.
- Empiric bronchodilator therapy is advised for patients with dry nocturnal cough exceeding three weeks.
- The overall prognosis for chronic cough is generally favorable.
Impact:
- Improved diagnostic accuracy for chronic cough by considering distinct clinical presentations.
- Increased recognition and appropriate management of 'variant asthma' cough.
- Timely initiation of effective treatment for persistent nocturnal cough, potentially improving patient quality of life.
Abstract:
Cough is a physiological reflex occurring when sensitive receptors located in upper airways and the larynx are activated. By definition a 'chronic cough' lasts at least 3 weeks. An analysis of clinical characteristics is essential for setting up the diagnosis and giving correct treatment. We can individualize three mainly clinical aspects: the young child of less than 3 years of age, the nocturnal cough and the productive cough. The 'variant of asthma' cough is a common problem among all ages that frequently goes unrecognized. Any patient with dry nocturnal coughing that lasts more than three weeks should have an empiric bronchodilator treatment. The prognosis is on the whole favourable.