Chronic cough. Diagnosis and treatment

Area of Science:

• Pulmonology
• Internal Medicine

Background:

• Cough is a prevalent symptom in patients presenting to physicians.
• Identifying the underlying cause is crucial for effective treatment.

Purpose of the Study:

• To outline diagnostic approaches for chronic cough in an outpatient setting.
• To highlight the utility of various clinical and laboratory procedures.

Main Methods:

• Comprehensive patient history and physical examination.
• Diagnostic imaging, including chest roentgenograms.
• Pulmonary function testing (PFTs) and bronchoprovocation challenges.
• Evaluation for chronic rhinosinusitis and postnasal drip.

Main Results:

• Chest roentgenograms can reveal infections (tuberculosis, fungal), bronchiectasis, lung abscess, or lung cancer.
• PFTs help differentiate obstructive (asthma, bronchitis) from restrictive (fibrosis) lung diseases.
• Bronchoprovocation testing aids in diagnosing conditions like cough-variant asthma when PFTs are normal.
• Chronic rhinosinusitis is a common cause, though often challenging to confirm diagnostically.

Conclusions:

• A majority of chronic cough cases can be diagnosed using standard outpatient clinical and laboratory methods.
• Integrated diagnostic strategies are essential for effective cough management.