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Chronic cough in children
Harrison Cash1, Samuel Trosman2, Thomas Abelson2
1Case Western Reserve University School of Medicine, Cleveland, Ohio.
Pediatric chronic cough diagnoses in otolaryngology differ from primary care, with infection, airway hyperreactivity, and GERD being most common. Treatment failure suggests airway hyperreactivity, warranting further investigation.
Area of Science:
- Otolaryngology
- Pediatric Pulmonology
- Pediatric Gastroenterology
Background:
- Chronic cough is a frequent pediatric complaint with limited diagnostic and therapeutic outcome data.
- Understanding causes and treatments in otolaryngology is crucial for effective patient management.
Purpose of the Study:
- To characterize pediatric chronic cough patients in otolaryngology clinics.
- Identify common etiologies and treatments for pediatric chronic cough.
- Evaluate the effectiveness of treatments for pediatric chronic cough.
Main Methods:
- Retrospective analysis of 58 pediatric patients with chronic cough (>4 weeks) from 2009-2013.
- Evaluation included history, physical exam, flexible laryngoscopy, imaging, and airway assessments.
- Treatment was based on working diagnoses, with outcomes assessed by cough resolution.
Main Results:
- Top diagnoses: infection (34%), airway hyperreactivity (24%), and gastroesophageal reflux disease (GERD) (24%).
- 83% of patients responded to initial treatment; 17% required further evaluation.
- Treatment failure strongly correlated with airway hyperreactivity (P<.001); chest radiography was more common and informative in these cases.
Conclusions:
- Pediatric chronic cough in otolaryngology settings presents differently than in primary care.
- Infection, airway hyperreactivity, and GERD are the leading causes.
- Persistent cough after initial treatment necessitates further evaluation, including chest radiography and pulmonary consultation.
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