Approach to Chronic Cough in Children
Year 2024,
, 451 - 457, 19.09.2024
Ece Tüsüz Önata
,
Ümmügülsüm Dikici
,
Öner Özdemir
Abstract
Cough is a very common complaint in children and can cause serious anxiety in families. Especially in the winter months, cough is a major reason for visits to physicians. There are many causes of cough, ranging from a simple upper respiratory tract infection to foreign body aspiration requiring emergency surgical intervention. Chronic cough is defined as a persistent and unremitting cough lasting longer than 4 weeks according to the ACCP (American College of Chest Physicians) guidelines and longer than 8 weeks according to the BTS (British Thoracic Society) guidelines. In the approach to chronic cough, a detailed history and a systematic physical examination are the cornerstones of the diagnosis. All patients should be evaluated with chest radiography and pulmonary function test if available, and in the presence of specific findings, investigations and treatment should be planned for the cause. In the absence of a specific cause, careful follow up and periodic evaluation are the current recommendations. This review summarizes the approach to children with chronic cough in light of current knowledge.
References
- Goldsobel AB, Chipps BE. Cough in the pediatric population. J Pediatr. 2010; 156(3): 352-8.
- Brooks SM. Perspective on the human cough reflex. Cough. 2011; 7: 10.
- Morris KF, Baekey DM, Nuding SC, Dick TE, Shannon R, Lindsey BG. Invited review: Neural network plasticity in respiratory control. J Appl Physiol (1985). 2003; 94(3): 1242-52.
- Chang AB. Cough, cough receptors, and asthma in children. Pediatr Pulmonol. 1999; 28(1): 59-70.
- Mukerji SS, Yenduri NJS, Chiou E, Moonnumakal SP, Bedwell JR. A multi-disciplinary approach to chronic cough in children. Laryngoscope Investig Otolaryngol. 2022; 7(2): 409-16.
- Sykes DL, Morice AH. The cough reflex: the janus of respiratory medicine. Front Physiol. 2021; 12: 684080.
- Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest. 2006; 129(1 Suppl): 260S-283S.
- Chang AB, Oppenheimer JJ, Irwin RS; CHEST expert cough panel. managing chronic cough as a symptom in children and management algorithms: CHEST guideline and expert panel report. Chest. 2020; 158(1): 303-29.
- Shields MD, Bush A, Everard ML, McKenzie S, Primhak R. British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax. 2008;63 Suppl 3:iii1-iii15.
- Morice AH, Millqvist E, Bieksiene K, Birring SS, Dicpinigaitis P, Domingo Ribas C. et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020; 55(1): 1901136.
- Chang AB, Oppenheimer JJ, Weinberger M, Grant CC, Rubin BK, Irwin RS; CHEST Expert Cough Panel. Etiologies of chronic cough in pediatric cohorts: CHEST Guideline and Expert Panel Report. Chest. 2017; 152(3): 607-17.
- Migliori GB, Sotgiu G, Rosales-Klintz S, Centis R, D’Ambrosio L, Abubakar I, et al. ERS/ECDC statement: European Union standards for tuberculosis care, 2017 update. Eur Respir J. 2018; 51(5): 1702678.
- Gilchrist FJ. An approach to the child with a wet cough. Paediatr Respir Rev. 2019; 31: 75-81.
- Tatar M, Plevkova J, Brozmanova M, Pecova R, Kollarik M. Mechanisms of the cough associated with rhinosinusitis. Pulm Pharmacol Ther. 2009; 22(2): 121-6.
- Achilleos A. Evidence-based evaluation and management of chronic cough. Med Clin North Am. 2016; 100(5): 1033-45.
- Devonshire AL, Kumar R. Pediatric asthma: Principles and treatment. Allergy Asthma Proc. 2019; 40(6): 389-92.
- Lee AS, Lee JS, He Z, Ryu JH. Reflux-aspiration in chronic lung disease. Ann Am Thorac Soc. 2020; 17(2): 155-64.
- Asilsoy PDS. Çocuklarda Kronik Öksürüğe Yaklaşım. Pediatri. 2017; 9(2): 6-12.
- Marchant JM, Masters IB, Taylor SM, Cox NC, Seymour GJ, Chang AB. Evaluation and outcome of young children with chronic cough. Chest. 2006; 129(5): 1132-41.
- Matsumoto H, Niimi A, Takemura M, Ueda T, Yamaguchi M, Matsuoka H, et al. Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study. Cough. 2009; 5: 3.
- Selvadurai H. Investigation and management of suppurative cough in pre-school children. Paediatr Respir Rev. 2006; 7(1): 15-20.
- Wu J, Zhong W, Yin Y, Zhang H. Primary immunodeficiency disease: a retrospective study of 112 Chinese children in a single tertiary care center. BMC Pediatr. 2019; 19(1): 410.
- Overlack A. ACE inhibitor-induced cough and bronchospasm. Incidence, mechanisms and management. Drug Saf. 1996; 15(1): 72-8.
- Traisman ES. Clinical evaluation of chronic cough in children. Pediatr Ann. 2015; 44(8): 303-7.
- Raman R. Impacted ear wax—a cause for unexplained cough? Arch Otolaryngol Head Neck Surg. 1986; 112(6): 679.
- Fouzas S, Anthracopoulod MB, Bohadana A. Clinical usefulness of breath sounds. In: Priftis KN, Hadjileontiadis L, Everard M, editors. Breath sounds. Cham, Switzerland: Springer; 2018. p. 33-52.
- Kantar A, Chang AB, Shields MD, Marchant JM, Grimwood K, Grigg J, et al. ERS statement on protracted bacterial bronchitis in children. Eur Respir J. 2017; 50(2): pii:1602139.
- Kantar A. Phenotypic presentation of chronic cough in children. J Thorac Dis. 2017; 9(4): 907-13.
- Danvers L, Lo DKH, Gaillard EA. The role of objective tests to support a diagnosis of asthma in children. Paediatr Respir Rev. 2020; 33: 52-7.
- Goldsobel A, Chipps B. Cough in the pediatric population. J Pediatr 2010; 156(3): 352-58.e1.
- Marchant JM, Masters IB, Taylor SM, Chang AB. Utility of signs and symptoms of chronic cough in predicting specific cause in children. Thorax 2006; 61: 694-8.
- Das S, Sockrider M. Protracted bacterial bronchitis (PBB) in children. Am J Respir Crit Care Med. 2018; 198(6): P11-P12.
- Weintraub B. Upper respiratory tract infections. Pediatr Rev. 2015; 36(12): 554-6.
- Cheng ZR, Chua YX, How CH, Tan YH. Approach to chronic cough in children. Singapore Med J. 2021; 62(10): 513-9.
- Munyard P, Bush A. How much coughing is normal? Arch Dis Child. 1996; 74(6): 531-4.
- Chang AB. Cough: are children really different to adults? Cough. 2005; 1: 7.
- Zgherea D, Pagala S, Mendiratta M, Marcus MG, Shelov SP, Kazachkov M. Bronchoscopic findings in children with chronic wet cough. Pediatrics. 2012; 129(2): e364-9
- Poulose V, Tiew PY, How CH. Approaching chronic cough. Singapore Med J 2016; 57: 60-3.
- Tekdemir I, Aslan A, Elhan A. A clinico-anatomic study of the auricular branch of the vagus nerve and Arnold's ear-cough reflex. Surg Radiol Anat. 1998; 20(4): 253-7.
- Yilmaz O, Bakirtas A, Ertoy Karagol HI, Topal E, Turktas I. Children with chronic nonspecific isolated cough. Chest. 2014; 145: 1279-85.
- Alviani C, Ruiz G, Gupta A. Fifteen-minute consultation: A structured approach to the management of chronic cough in a child. Arch Dis Child Educ Pract Ed. 2018; 103(2): 65-70.
- Devonshire AL, Kumar R. Pediatric asthma: principles and treatment. Allergy Asthma Proc. 2019; 40(6): 389-92.
Çocuklarda Kronik Öksürüğe Yaklaşım
Year 2024,
, 451 - 457, 19.09.2024
Ece Tüsüz Önata
,
Ümmügülsüm Dikici
,
Öner Özdemir
Abstract
Öksürük çocuklarda çok sık rastlanan bir yakınma olup, ailelerde ciddi anksiyeteye neden olabilmektedir. Özellikle kış aylarında hekimlere başvuru sebeplerinin büyük bir kısmını öksürük şikâyeti oluşturmaktadır. Öksürüğün basit bir üst solunum yolu enfeksiyonundan acil cerrahi girişim gerektiren yabancı cisim aspirasyonuna kadar pek çok nedeni vardır. Kronik öksürük, ACCP (American College of Chest Physicians) kılavuzuna göre 4 haftadan; BTS (British Thoracic Society) kılavuzuna göre 8 haftadan uzun süren inatçı ve aralıksız öksürük olarak tanımlanmıştır. Kronik öksürüğe yaklaşımda hastadan alınacak ayrıntılı bir öykü ve hastaya yapılacak sistemsel bir fizik muayene tanının temel taşıdır. Tüm hastalar akciğer grafisi ve yapılabiliyorsa solunum fonksiyon testi ile değerlendirilmeli, bunlara göre spesifik bulguların varlığında nedene yönelik tetkik ve tedavi planlanmalıdır. Spesifik bir neden bulunamadığında ise dikkatli izlem ve periyodik değerlendirme ile takip edilmesi güncel önerilerdir. Bu derlemede kronik öksürüklü çocuklara yaklaşım güncel bilgiler ışığında özetlenmiştir.
References
- Goldsobel AB, Chipps BE. Cough in the pediatric population. J Pediatr. 2010; 156(3): 352-8.
- Brooks SM. Perspective on the human cough reflex. Cough. 2011; 7: 10.
- Morris KF, Baekey DM, Nuding SC, Dick TE, Shannon R, Lindsey BG. Invited review: Neural network plasticity in respiratory control. J Appl Physiol (1985). 2003; 94(3): 1242-52.
- Chang AB. Cough, cough receptors, and asthma in children. Pediatr Pulmonol. 1999; 28(1): 59-70.
- Mukerji SS, Yenduri NJS, Chiou E, Moonnumakal SP, Bedwell JR. A multi-disciplinary approach to chronic cough in children. Laryngoscope Investig Otolaryngol. 2022; 7(2): 409-16.
- Sykes DL, Morice AH. The cough reflex: the janus of respiratory medicine. Front Physiol. 2021; 12: 684080.
- Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest. 2006; 129(1 Suppl): 260S-283S.
- Chang AB, Oppenheimer JJ, Irwin RS; CHEST expert cough panel. managing chronic cough as a symptom in children and management algorithms: CHEST guideline and expert panel report. Chest. 2020; 158(1): 303-29.
- Shields MD, Bush A, Everard ML, McKenzie S, Primhak R. British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax. 2008;63 Suppl 3:iii1-iii15.
- Morice AH, Millqvist E, Bieksiene K, Birring SS, Dicpinigaitis P, Domingo Ribas C. et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J. 2020; 55(1): 1901136.
- Chang AB, Oppenheimer JJ, Weinberger M, Grant CC, Rubin BK, Irwin RS; CHEST Expert Cough Panel. Etiologies of chronic cough in pediatric cohorts: CHEST Guideline and Expert Panel Report. Chest. 2017; 152(3): 607-17.
- Migliori GB, Sotgiu G, Rosales-Klintz S, Centis R, D’Ambrosio L, Abubakar I, et al. ERS/ECDC statement: European Union standards for tuberculosis care, 2017 update. Eur Respir J. 2018; 51(5): 1702678.
- Gilchrist FJ. An approach to the child with a wet cough. Paediatr Respir Rev. 2019; 31: 75-81.
- Tatar M, Plevkova J, Brozmanova M, Pecova R, Kollarik M. Mechanisms of the cough associated with rhinosinusitis. Pulm Pharmacol Ther. 2009; 22(2): 121-6.
- Achilleos A. Evidence-based evaluation and management of chronic cough. Med Clin North Am. 2016; 100(5): 1033-45.
- Devonshire AL, Kumar R. Pediatric asthma: Principles and treatment. Allergy Asthma Proc. 2019; 40(6): 389-92.
- Lee AS, Lee JS, He Z, Ryu JH. Reflux-aspiration in chronic lung disease. Ann Am Thorac Soc. 2020; 17(2): 155-64.
- Asilsoy PDS. Çocuklarda Kronik Öksürüğe Yaklaşım. Pediatri. 2017; 9(2): 6-12.
- Marchant JM, Masters IB, Taylor SM, Cox NC, Seymour GJ, Chang AB. Evaluation and outcome of young children with chronic cough. Chest. 2006; 129(5): 1132-41.
- Matsumoto H, Niimi A, Takemura M, Ueda T, Yamaguchi M, Matsuoka H, et al. Features of cough variant asthma and classic asthma during methacholine-induced brochoconstriction: a cross-sectional study. Cough. 2009; 5: 3.
- Selvadurai H. Investigation and management of suppurative cough in pre-school children. Paediatr Respir Rev. 2006; 7(1): 15-20.
- Wu J, Zhong W, Yin Y, Zhang H. Primary immunodeficiency disease: a retrospective study of 112 Chinese children in a single tertiary care center. BMC Pediatr. 2019; 19(1): 410.
- Overlack A. ACE inhibitor-induced cough and bronchospasm. Incidence, mechanisms and management. Drug Saf. 1996; 15(1): 72-8.
- Traisman ES. Clinical evaluation of chronic cough in children. Pediatr Ann. 2015; 44(8): 303-7.
- Raman R. Impacted ear wax—a cause for unexplained cough? Arch Otolaryngol Head Neck Surg. 1986; 112(6): 679.
- Fouzas S, Anthracopoulod MB, Bohadana A. Clinical usefulness of breath sounds. In: Priftis KN, Hadjileontiadis L, Everard M, editors. Breath sounds. Cham, Switzerland: Springer; 2018. p. 33-52.
- Kantar A, Chang AB, Shields MD, Marchant JM, Grimwood K, Grigg J, et al. ERS statement on protracted bacterial bronchitis in children. Eur Respir J. 2017; 50(2): pii:1602139.
- Kantar A. Phenotypic presentation of chronic cough in children. J Thorac Dis. 2017; 9(4): 907-13.
- Danvers L, Lo DKH, Gaillard EA. The role of objective tests to support a diagnosis of asthma in children. Paediatr Respir Rev. 2020; 33: 52-7.
- Goldsobel A, Chipps B. Cough in the pediatric population. J Pediatr 2010; 156(3): 352-58.e1.
- Marchant JM, Masters IB, Taylor SM, Chang AB. Utility of signs and symptoms of chronic cough in predicting specific cause in children. Thorax 2006; 61: 694-8.
- Das S, Sockrider M. Protracted bacterial bronchitis (PBB) in children. Am J Respir Crit Care Med. 2018; 198(6): P11-P12.
- Weintraub B. Upper respiratory tract infections. Pediatr Rev. 2015; 36(12): 554-6.
- Cheng ZR, Chua YX, How CH, Tan YH. Approach to chronic cough in children. Singapore Med J. 2021; 62(10): 513-9.
- Munyard P, Bush A. How much coughing is normal? Arch Dis Child. 1996; 74(6): 531-4.
- Chang AB. Cough: are children really different to adults? Cough. 2005; 1: 7.
- Zgherea D, Pagala S, Mendiratta M, Marcus MG, Shelov SP, Kazachkov M. Bronchoscopic findings in children with chronic wet cough. Pediatrics. 2012; 129(2): e364-9
- Poulose V, Tiew PY, How CH. Approaching chronic cough. Singapore Med J 2016; 57: 60-3.
- Tekdemir I, Aslan A, Elhan A. A clinico-anatomic study of the auricular branch of the vagus nerve and Arnold's ear-cough reflex. Surg Radiol Anat. 1998; 20(4): 253-7.
- Yilmaz O, Bakirtas A, Ertoy Karagol HI, Topal E, Turktas I. Children with chronic nonspecific isolated cough. Chest. 2014; 145: 1279-85.
- Alviani C, Ruiz G, Gupta A. Fifteen-minute consultation: A structured approach to the management of chronic cough in a child. Arch Dis Child Educ Pract Ed. 2018; 103(2): 65-70.
- Devonshire AL, Kumar R. Pediatric asthma: principles and treatment. Allergy Asthma Proc. 2019; 40(6): 389-92.