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Source: Am Fam Physician  |  Posted 8 years ago

Evaluation of the patient with chronic cough; Benich JJ, Carek PJ; American Family Physician 84 (8), 887-92 (Oct 2011)

Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks' duration) should include a focused history and physical examination, and in most patients, chest radiography. Patients who are taking an angiotensin-converting enzyme inhibitor should switch to a medication from another drug class. The most common causes of chronic cough in adults are upper airway cough syndrome, asthma, and gastroesophageal reflux disease, alone or in combination. If upper airway cough syndrome is suspected, a trial of a decongestant and a first-generation antihistamine is warranted. The diagnosis of asthma should be confirmed based on clinical response to empiric therapy with inhaled bronchodilators or corticosteroids. Empiric treatment for gastroesophageal reflux disease should be initiated in lieu of testing for patients with chronic cough and reflux symptoms. Patients should avoid exposure to cough-evoking irritants, such as cigarette smoke. Further testing, such as high-resolution computed tomography, and referral to a pulmonologist may be indicated if the cause of chronic cough is not identified. In children, a cough lasting longer than four weeks is considered chronic. The most common causes in children are respiratory tract infections, asthma, and gastroesophageal reflux disease. Evaluation of children with chronic cough should include chest radiography and spirometry.

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Comments

Add michel.rosenheim as a colleague

What about whooping cough, especially in an adult?

Add missa_1959 as a colleague

what is the last most accurate tool for diagnosis of whooping cough?

Add daneshnia as a colleague

The character of the cough in whooping cough goes a different way from the other coughings in 95% of cases.

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