Children's Cough Causes and Treatments - Chronic Cough
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What are the common causes of chronic cough in children?
Many of the causes (etiologies) of acute cough discussed above may also
persist greater than four weeks and thus be classified as chronic cough.
Two causes of acute cough which generally have a shorter than four week lifespan
include: upper repsiratory infections (generally a maximum of 2 week duration) and croup (generally 4
day duration). Some studies have estimated that 5% to 7 % of
preschoolers and 12 to 15 percent of older children may have chronic cough.
Males are more likely to have chronic cough than female,s and chronic cough is
more likely in underdeveloped countries than in those more affluent.
Causes of chronic cough (in addition to those listed above for acute cough)
Irritation of the airways: pollution, primary or
secondhand smoke, and
an allergen may also produce persisting cough. Elimination or
reduction of the offending irritant is therapeutic.
Increase in cough receptor sensitivity: Some children
seem to have a more sensitive response to irritants than their peers. The
mechanism for this increase in cough receptor sensitivity is not well defined at
this time. Possibilities under consideration include inflammation, erosion
of the surface cell layer of the airway or a sensitization of the airway.
The diagnosis may be explored in research centers using a cough-inducing
irritant (capsaicin) as a quantifiable stimulant. Interpretation of such
data is in the infancy stage.
Habit cough: This cough has both a psychological and
physical component. While often triggered by the common upper repsiratory
infection, the duration
of cough symptoms far exceeds the duration of the viral infection. Parents
will describe a distinctive quality of cough: short, dry, single episodes that
may mimic a benign motor tic (see above). Unlike a tic, the cough may be
quite loud and disruptive to the classroom setting. The cough is commonly
present during a medical evaluation but it does not characteristically interfere
with play, sleep, talking, or eating. No specific diagnostic evaluation
exists and habit cough is a diagnosis of exclusion. Counseling is
generally an effective management technique.
Otogenic cough: A minority of individuals have a branch
of the nerve used in the cough reflex lining the ear canal. Irritation of
the canal (Q-tips, was [cerumen], etc.) may cause irritation of this nerve and thus
induce a persisting and non-productive cough. While this is a relatively
rare cause of children's cough, removal of the offending agent is curative.