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Persistent cough: causes and cures
1Mayo Clinic, Rochester, Minn, USA.
Hospital Practice (1995)
|September 15, 1996
Summary
Refractory cough with a normal chest X-ray often stems from five causes, including medications, postnasal drip, reflux, or airway issues. Empiric therapy guided by patient history can identify the specific cause and confirm diagnosis.
Area of Science:
- Pulmonology
- Internal Medicine
Background:
- Refractory cough presents a diagnostic challenge, particularly when chest X-rays are normal.
- Identifying the underlying cause is crucial for effective patient management.
Observation:
- A normal chest X-ray in patients with persistent cough suggests non-structural etiologies.
- Common causes include drug-induced cough (e.g., ACE inhibitors), postnasal discharge, gastroesophageal reflux, and hyperactive airway disease.
Findings:
- Idiopathic cough, responsive to nebulized lidocaine, represents another distinct category.
- Patient history is a key tool in pinpointing the most probable cause of refractory cough.
- Empiric therapeutic trials can serve to confirm the suspected diagnosis.
Implications:
- This diagnostic framework aids clinicians in systematically evaluating refractory cough.
- Targeted empiric therapy can lead to quicker symptom resolution and improved patient outcomes.
- Understanding these categories is essential for managing chronic cough effectively.