US EPA

3976119 

Journal Article 

Clinical symptoms and differential diagnostics of cough 

Dittrich, AM; Hansen, G; Schwerk, N 

2015 

1 

Monatsschrift Kinderheilkunde
ISSN: 0026-9298
EISSN: 1433-0474 

163 

12 

1230-1240 

10.1007/s00112-015-3383-y 

WOS:000365806000007 

Cough is one of the most common reasons for consulting a pediatrician. A pediatrician's main tasks when confronted with a coughing child are to a) differentiate a normal from an abnormal cough, b) distinguish acute, subacute and chronic cough by a detailed patient history and c) perform a thorough physical examination to find signs and symptoms of underlying diseases. All children who present with a cough must be systematically examined. Even if the results of a physical examination are apparently normal, a potentially severe underlying disease cannot be excluded. Determination of the body weight and height, comparison with a percentile chart, measurement of the breathing rate and oxygen saturation are obligatory. Clarification of these aspects ensures that a child with an abnormal cough will undergo targeted diagnostic steps to reach a definitive diagnosis as quickly as possible. This definitive diagnosis is important in order to prevent irreversible sequelae, such as loss of lung parenchyma and bronchiectasis resulting from chronic airway inflammation where coughing can be the only symptom. In most cases, however, coughing is a symptom of a benign viral airway infection and does not necessitate further diagnostic procedures or therapy. The demanding challenge for the pediatrician is, therefore, to identify those children with a severe underlying disease that needs immediate treatment and simultaneously to distinguish them from those essentially healthy children in order to prevent unnecessary invasive procedures. In this article systematic proposals for an efficient and structured diagnostic approach to the coughing child are presented. 

Infection; Chronic disease; Bronchiectasis; Inflammation; Algorithms