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History Taking as a Diagnostic Tool in Children With Chronic Cough
Ahmad Kantar1,2, Julie M Marchant3,4, Woo-Jung Song5
1Paediatric Asthma and Cough Centre, Gruppo Ospedaliero San Donato, Bergamo, Italy.
Insights
Accurate respiratory history is crucial for diagnosing chronic cough in children. This article details key questions physicians should ask to identify underlying causes and improve patient care.
Area of Science:
- Pediatrics
- Pulmonology
- Clinical Medicine
Background:
- Chronic cough is a prevalent symptom in children, often indicating underlying conditions.
- Pediatric chronic cough management differs from adults, necessitating specific diagnostic approaches.
- Current guidelines emphasize history, physical exam, and investigations, but physician expertise in history-taking is vital.
Purpose of the Study:
- To outline essential questions for a detailed respiratory history in children with chronic cough.
- To highlight the importance of skilled history-taking in diagnosing pediatric chronic cough.
- To provide a framework for physicians to improve diagnostic accuracy and patient management.
Main Methods:
- Review of existing literature and clinical guidelines on pediatric chronic cough.
- Identification of key historical elements for differentiating causes of chronic cough.
- Compilation of a comprehensive list of questions for physician use.
Main Results:
- Detailed history-taking is a cornerstone for identifying the pathophysiological basis of chronic cough.
- Specific questions can aid in pinpointing likely diagnoses and guiding further investigations.
- Skilled physician questioning enhances diagnostic precision and treatment tailoring.
Conclusions:
- A thorough, targeted respiratory history is paramount for effective chronic cough management in children.
- This article provides a practical guide for physicians to optimize history-taking for pediatric chronic cough.
- Improving history-taking skills can lead to better patient outcomes and reduced diagnostic delays.
Abstract:
Chronic cough is a common symptom of many underlying respiratory and non-respiratory disorders and may be associated with less serious causes, such as gastroesophageal reflux and nasal diseases. Chronic cough in children differs from that in adults with respect to its etiologies and management since it can indicate a symptom of an underlying disease in children. Guidelines for managing chronic cough in children are based on recording the history, followed by physical examination, chest radiography, and spirometry. Thus, taking accurate respiratory history for coughing helps delineate the pathophysiological basis of the cause of chronic cough. Detailed history taking enhances the evaluation and treatment, and facilitates a tailored diagnostic identification of likely diagnoses. While studies have described evidence-based red flags in children with chronic cough, the value of skilled physicians regarding history taking has received less attention for the best patient care. In the present article, we outline the major questions comprising a detailed history taking for chronic cough in children.
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