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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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