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A multi-disciplinary approach to chronic cough in children
Shraddha S Mukerji1, Naga Jaya Smitha Yenduri2, Eric Chiou3
1Department of Otolaryngology Head Neck Surgery Baylor College of Medicine, Texas Children's Hospital Houston Texas USA.
Insights
Common causes of chronic cough in children include persistent bacterial bronchitis, asthma, and GERD. A multidisciplinary approach aids diagnosis and treatment for pediatric cough.
Area of Science:
- Pediatric Pulmonology
- Pediatric Otolaryngology
- Pediatric Gastroenterology
Background:
- Chronic cough (CC) and recurrent cough (RC) are common pediatric complaints.
- Identifying underlying causes is crucial for effective management.
- A systematic approach is needed to address complex pediatric cough cases.
Purpose of the Study:
- To identify key etiologies of chronic and recurrent cough in children.
- To emphasize the importance of a multidisciplinary approach in managing pediatric cough.
Main Methods:
- A comprehensive review of scholarly articles, clinical guidelines, and expert panel reports.
- Literature search conducted using PubMed and Google Scholar.
Main Results:
- Key causes of pediatric chronic cough include persistent bacterial bronchitis, asthma, nonspecific cough, and gastroesophageal reflux disease (GERD).
- Subglottic stenosis is a primary ENT cause of recurrent croup (RC).
- Laryngeal cleft type 1 is associated with recurrent aspiration and chronic cough.
- Eosinophilic esophagitis (EoE) and GERD are important considerations in children with respiratory symptoms and failure to thrive.
Conclusions:
- A multidisciplinary approach facilitates cost-effective and timely diagnosis and treatment of pediatric cough.
- Early recognition of conditions like subglottic stenosis and laryngeal clefts is vital.
- Considering gastrointestinal causes like GERD and EoE is essential in the differential diagnosis of refractory pediatric cough.
Objectives:
(1) To highlight the important causes of chronic and recurrent cough in children. (2) To discuss multidisciplinary approach to management of chronic/recurrent pediatric cough.
Methods:
Review of scholarly articles, guidelines, expert panels via PubMed and Google Scholar.
Conclusion:
Chronic cough (CC) in children is mainly attributed to persistent bacterial bronchitis, asthma, nonspecific cough, and gastroesophageal reflux disease (GERD) symptoms. A multi-disciplinary approach is cost-effective and aids with earlier diagnosis and appropriate treatment. Congenital or acquired narrowing of the subglottis is the leading ENT cause for recurrent croup (RC) in children. Laryngeal cleft-type 1 is commonly seen in children with recurrent aspiration and CC. Children are usually referred to pulmonologists for wet cough not responding to treatment. Eosinophilic esophagitis (EoE) and GERD should be considered in the differential diagnosis of CC in children with both respiratory symptoms and failure to thrive.Level of Evidence: 2a.
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