COMMON INFECTIONS OF CHILDHOOD: COUGH CAUSE AND CLINICAL FEATURES
Cough is one of the commonest symptoms of childhood and is sometimes difficult to treat. A cough tends to linger on in young children, often disturbing sleep and everyday functioning, and is distressing to children and parents alike.
Cause
There are many causes of a cough in children, including infections (both viral and bacterial), irritations (cold air, smoke, inhaled foreign body), allergies (asthma, though strictly speaking it is not always allergic), as well as psychological causes (habit cough).
By far the commonest cause of cough is a viral infection; as part of and after a cold, the child may tend to cough for a period of time. The next most common cause of cough is asthma, in which the child will usually have other symptoms as well, such as a wheeze, but sometimes a cough, especially at night or after exercise, may be the only feature. Other causes of a cough are relatively uncommon.
Clinical features
The exact nature of the cough and any associated symptoms will vary according to its cause. A cough that follows a cold will be loose and sometimes produce mucus.
Often it is worse at night because of post-nasal drip from a still congested upper respiratory tract. The cough may persist for weeks after the other symptoms of the cold have disappeared.
The cough of asthma is worse at night or after exercise, and there may be an associated wheeze and breathing difficulties such as shortness of breath. A barking, hoarse cough is suggestive of croup, while a sudden onset of a cough following a choking episode may suggest an inhaled foreign body.
Investigations
Most children with a cough do not need any investigations, and the diagnosis is made on the basis of careful history and physical examination. In some instances, a chest X-ray will be taken in cases of asthma or to rule out an inhaled foreign body. A blood test may help in the diagnosis of infection.
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