Recurrent Cough
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Recurrent Cough

This is a very common complain for children. Common causes include:
Asthmathe most common cause of childhood cough. Typically symptoms (such as wheeze and breathlessness may not always be present, particularly in younger children. The only sign may be a problematic night-time cough.  Although you should not diagnose asthma before the age of 5 many of these patients will benefit from treatment (e.g. a ‘brown’ and a ‘blue’ inhaler).
Recurrent respiratory infection
  • Single respiratory infection – certain infectious agents can cause a cough that lasts for several months, even when other symptoms have subsided. Examples include RSV, mycoplasma and pertussis.
Lobar collapse – rare but could result from a previous infection, and will be visible on x-ray
TB if the cough is especially persistent, you should test for TB (CXR and Mantoux)
Gastro-oesophageal refluxmay cause aspiration of feeds, which can cause persistent cough. This may also occur in those that have swallowing difficulties – e.g. cerebral palsy.
‘Habit cough’ – after a respiratory infection, some children develop a habitual cough. It is notably absent during the night. Parental guidance and reassurance is beneficial.
Smoking! – parental smoking in younger children, and possibly child smoking in older patients:
  • 10% of 11-15 year olds smoke
  • 30% of 16-19 year olds smoke
Inhaled Foreign Body
Allergic rhinitis – can cause a persistent nasal discharge, which can result in night-time cough via postnatal discharge.
  • Allergic rhinitis is the result of a chronic state of inflammation of the mucus membranes in the nose, which subsequently produce excessive mucous. It is commonly seen in allergy, such as hay-fever, and thus is also often associated with atopic individuals.

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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