Chest
Original Research: CoughEvaluation and Outcome of Young Children With Chronic Cough
Section snippets
Subjects
Any child (ie, age < 18 years) with chronic cough of unknown etiology who was referred to the pediatric respiratory practice at our university hospital between June 2002 and June 2004 was invited to participate. Chronic cough was defined as a cough of > 3 weeks duration.11, 14 The children attended an initial visit, which included a detailed medical history and physical examination using a standardized data collection sheet. The history included the duration and character of the cough, family
Results
The median age of the 108 young children studied (51 male, 57 female) was 2.6 years (IQR, 1.2 to 6.9 years). These children were recruited from 114 who had been invited to participate. The main reason for nonparticipation was an unwillingness to complete the cough diaries and/or further investigations. The prestudy diagnoses were asthma (n = 54; 50%), no preexisting diagnosis (n = 34; 31.5%), and bronchitis (n = 2; 2%), and patients were referred from pediatricians (n = 56; 52%) and general
Discussion
This is the first study that has prospectively evaluated young children using a modified protocol based on the protocol of Irwin et al11 for chronic cough in adults. We have found that the diagnostic categories for chronic cough in children are heterogeneous and that the most common diagnosis was PBB, with the three most common diagnoses of chronic cough in adults (ie, asthma, UACS, or GERD)14 being found in only 9% of young children.
Adult studies30 have described that a systematic evaluation
ACKNOWLEDGMENT
The authors sincerely thank the children and their parents who so willingly participated in the study; and Dr. Paul Francis, Dr. Claire Wainwright, Professor Alan Isles, and Dr. Nigel Dore for their assistance with patient recruitment.
References (48)
- et al.
Idiopathic cough, prevalence and underlying mechanisms
Pulm Pharmacol Ther
(2004) - et al.
Managing cough as a defense mechanism and as a symptom: a consensus panel report of the American College of Chest Physicians
Chest
(1998) - et al.
HRCT of paediatric lung disease
Paediatr Respir Rev
(2000) - et al.
Induced sputum: comparison of postinfectious cough with allergic asthma in children
J Allergy Clin Immunol
(2000) - et al.
Congenital vascular anomalies and persistent respiratory symptoms in children
Int J Pediatr Otorhinolaryngol
(1999) Primary bronchomalacia in infants and children
J Pediatr
(1997)- et al.
Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease
Am J Med
(2000) - et al.
Frequency and site of gastroesophageal reflux in patients with chest symptoms: studies using proximal and distal pH monitoring
Chest
(1994) - et al.
Research applications of bronchoscopy
Paediatr Respir Rev
(2003) - et al.
Chronic cough with a history of excessive sputum production: the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy
Chest
(1995)
Bettering the evaluation and care of health: a study of general practice activity
Why do mothers consult when their children cough?
Fam Pract
Over-the-counter medication use among preschool-age children
JAMA
Respiratory symptoms, bronchitis and asthma in children of central and eastern Europe
Eur Respir J
Chronic cough in infants and children
Laryngoscope
Persistent cough in children: overuse of medications
J Paediatr Child Health
Etiology of chronic cough in a population of children referred to a pediatric pulmonologist
J Am Board Fam Pract
Bronchoalveolar cell profiles in children with asthma, infantile wheeze, chronic cough, or cystic fibrosis
Am J Respir Crit Care Med
Chronic cough in children: bronchoalveolar lavage findings
Eur Respir J
Airway eosinophilia is associated with wheeze but is uncommon in children with persistent cough and frequent chest colds
Am J Respir Crit Care Med
Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy
Am Rev Respir Dis
Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol
Thorax
Cough: are children really different to adults?
Cough
Developmental airway cell biology: the “normal” young child
Am J Respir Crit Care Med
Cited by (0)
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
Dr. Marchant is supported by the Royal Children's Hospital Foundation, Brisbane. Dr. Chang is funded by a Practitioner Fellowship from the National Health and Medical Research Council, Australia.
No authors have any known conflicts of interest to disclose.