{"id":1830,"date":"2017-12-12T16:02:42","date_gmt":"2017-12-12T16:02:42","guid":{"rendered":"http:\/\/papergp.com\/index.php\/paediatrics\/chronic-cough-in-a-child\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"chronic-cough-in-a-child","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/paediatrics\/chronic-cough-in-a-child\/","title":{"rendered":"Chronic cough in a child"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>The normal, well child\n<ul>\n<li>Post viral<\/li>\n<li>Psychogenic cough<\/li>\n<\/ul>\n<\/li>\n<li>Non-serious, treatable illness\n<ul>\n<li>GORD<\/li>\n<li>Post nasal drip<\/li>\n<\/ul>\n<\/li>\n<li>Asthma syndrome\n<ul>\n<li>Wheeze, Diurnal variation, Exercise, Cold air, Pets<\/li>\n<\/ul>\n<\/li>\n<li>Serious underlying illness\n<ul>\n<li>CF, Bronchiectasis &#8211; Neonatal onset, productive cough<\/li>\n<li>Retained inhaled foreign body &#8211; Very acute onset<\/li>\n<li>Other infections\n<ul>\n<li>TB, Pertussis (paroxysms with inspiratory whoop), Mycoplasma pneumoniae, Chlamydia<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>Immune deficiencies<\/li>\n<li>Primary ciliary disorders<\/li>\n<li>Recurrent pulmonary aspiration<\/li>\n<li>Anatomical Disorder &#8211; Tracheomalacia<\/li>\n<li>Interstitial lung disease &#8211; Shortness of breath<\/li>\n<li>Cardiac disease<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>Neonatal onset<\/li>\n<li>Chronic moist cough with sputum production<\/li>\n<li>Failure to thrive<\/li>\n<li>Family history of lung disease<\/li>\n<li>Haemoptysis<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>DIB<\/li>\n<li>Triggers<\/li>\n<li>URTI symptoms<\/li>\n<li>Relation to meals, Lying down<\/li>\n<li>Wheeze, Diurnal variation, Exercise, Cold air, Pets<\/li>\n<li>Smoking at home<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Examination\n<ul>\n<li>HR, Sats, RR<\/li>\n<li>Chest, CVS, ENT<\/li>\n<li>Clubbing, Nasal polyps &#8211; ?CF<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>CXR<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Monitor<\/li>\n<li>Parental smoking cessation<\/li>\n<li>Depending on cause\n<ul>\n<li>Trial of Salbutamol\/spacer + Beclometasone 200mcg BD for 8 weeks\n<ul>\n<li>upon improvement, the ICS should be stopped and a diagnosis of asthma should only be made if cough reoccurs<\/li>\n<\/ul>\n<\/li>\n<li>Trial of Gaviscon + Ranitidine<\/li>\n<li>Trial of prolonged course of antibiotics\n<ul>\n<li>e.g. co-amoxiclav for 2-3 weeks<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net\n<ul>\n<li>90% of coughs settle within 4 weeks &#8211; consider investigating earlier if not starting to improve\u00a0or deterioration<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Notes<\/h4>\n<ul>\n<li>Duration\n<ul>\n<li>Normal &#8211; up to 4 weeks<\/li>\n<li>Subacute cough &#8211; 3-8 weeks<\/li>\n<li>Chronic cough &#8211; &gt; 8 weeks<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis The normal, well child Post viral Psychogenic cough Non-serious, treatable illness GORD Post nasal drip Asthma syndrome Wheeze, Diurnal variation, Exercise, Cold air, Pets Serious underlying illness CF, Bronchiectasis &#8211; Neonatal onset, productive cough Retained inhaled foreign body &#8211; Very acute onset Other infections TB, Pertussis (paroxysms with inspiratory whoop), Mycoplasma pneumoniae, Chlamydia &hellip; <a href=\"https:\/\/papergp.com\/index.php\/paediatrics\/chronic-cough-in-a-child\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Chronic cough in a child<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":96,"menu_order":77,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1830","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1830","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1830"}],"version-history":[{"count":7,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1830\/revisions"}],"predecessor-version":[{"id":1946,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1830\/revisions\/1946"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/96"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1830"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}