DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201143

Evaluation of chronic cough in children aged 2 year to 12 years

Debbata Srikanth, Gangadhar B. Belavadi

Abstract


Background: Chronic cough is a common complaint in children which causes distress and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity. Aims and objectives of the study was to evaluate the specific diagnosis and prognosis of chronic cough in children aged 2 to 12 years.

Methods: A prospective study was done in 100 children with chronic cough (history of cough >4 weeks) at Narayana Hospital, Nellore. Routine investigations like complete blood count with differential count, Mantoux test, sputum examination, and X ray chest and other investigations like bronchoscopy, HIV, CT scan chest and paranasal sinuses, barium swallow, endoscopy and biopsy whenever needed. Pearson Chi square test carried out to quantify significance difference, p value <0.05, considered significant.

Results: The mean duration of chronic cough was 56.27 days (1-5 months). Most of the children belonged to <6 years age with higher boys’ prevalence. Breathlessness and fever noticed in 79% cases; it was found mostly in pneumonia cases as compared to other diagnosis (p=0.001). Sputum production noticed in 4, which found to be bronchiectasis. 1 case noticed with regurgitation, which is gastro oesphageal reflux disease. History of triggers for the symptoms of cough, wheeze and breathlessness is found to have a significant correlation with asthma (p=0.000). Asthma in 14% of cases, of which 12 were mild persistent and 2 were moderate persistent. Tuberculosis was diagnosed in 14% cases, Pneumonia in 12% cases, and Bronchiectasis in 12 cases. Undernourished children noticed in 56%, maximum number in tuberculosis group. Asthma was associated with pneumonia, mucous plug obstruction and collapse lung. Recurrent pneumonia was associated with airway anomaly, gastro esophageal reflux disease.

Conclusions: It should be remembered that a prolonged cough can be indicative of a more serious underlying condition, and always warrants thorough investigation.

 


Keywords


Asthma, Chronic cough, Pneumonia, Tuberculosis

Full Text:

PDF

References


Leonardi GS, Houthuijs D, Nikiforov B, Volf J, Rudnai P, Zejda J, et al. Respiratory symptoms, bronchitis and asthma in children of Central and Eastern Europe. Eur Resp J. 2002 Oct 1;20(4):890-8.

Kogan MD, Pappas G, Stella MY, Kotelchuck M. Over-the-counter medication use among US preschool-age children. JAMA. 1994 Oct 5;272(13):1025-30.

Black P. Evaluation of chronic or recurrent cough. Pediatric Respiratory Disease: Diagnosis and Treatment. Philadelphia: WB Saunders Company. 1993;143.

Britt H, Miller GC, Knox S, Charles J, Valenti L, Pan Y, et al. General practice activity in Australia 2003-04. Canberra: Australian Institute of Health and Welfare. 2004.

Cornford CS, Morgan M, Ridsdale L. Why do mothers consult when their children cough?. Fam Pract. 1993 Jul 1;10(2):193-6.

Thomson F, Masters IB, Chang AB. Persistent cough in children and the overuse of medications. J Paediatr Child Health. 2002 Dec;38(6):578-81.

Chang AB, Landau LI, Van Asperen PP, Glasgow NJ, Robertson CF, Marchant JM, et al. Cough in children: definitions and clinical evaluation. Med J Australia. 2006 Apr;184(8):398-403.

Irwin RS, Boulet LP, Cloutier MM, Fuller R, Gold PM, Hoffstein V. Managing cough as a defense mechanism and as a symptom. Chest 1998; 114:S133-81.

Holinger LD, Sanders AD. Chronic cough in infants and children: an update. Laryngoscope. 1991 Jun;101(6):596-605.

Bialy L, Domino FJ, Chang AB, Thomson D, Becker L. The Cochrane Library and chronic cough in children: an umbrella review. Evid‐Based Child Health: Cochrane Rev J. 2006 Sep;1(3):736-42.

Chang AB. Cough: are children really different to adults?. Cough. 2005 Dec 1;1(1):7.

Irwin RS, Baumann MH, Bolser DC, Boulet LP, Braman SS, Brightling CE, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan 1;129(1):1S-23S.

Marchant JM, Masters IB, Taylor SM, Chang AB. Utility of signs and symptoms of chronic cough in predicting specific cause in children. Thorax. 2006 Aug 1;61(8):694-8.

Marchant JM, Masters IB, Taylor SM, Cox NC, Seymour GJ, Chang AB. Evaluation and outcome of young children with chronic cough. Chest. 2006 May 1;129(5):1132-41.

Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan 1;129(1):260S-83S.

Morice AH, McGarvey L, Pavord I. Recommendations for the management of cough in adults. Thorax. 2006 Sep 1;61(suppl 1):i1-24.

Morice AH. The diagnosis and management of chronic cough. Eur Resp J. 2004 Sep 1;24(3):481-92.

Dani VS, Mogre SS, Saoji R. Evaluation of chronic cough in children: clinical and diagnostic spectrum and outcome of specific therapy. Ind Pediatr. 2002;39(1):63-9.

Singh D, Arora V, Sobti PC. Chronic/recurrent cough in rural children in Ludhiana, Punjab. Ind Pediatr. 2002 Jan;39(1):23-9.

Asilsoy S, Bayram E, Agin H, Apa H, Can D, Gulle S, et al. Evaluation of chronic cough in children. Chest. 2008 Dec 1;134(6):1122-8.

Awasthi S, Kalra E, Roy S, Awasthi S. Prevalence and risk factors of asthma and wheeze in school-going children in Lucknow, North India. Ind Pediatr. 2004 Dec 30;41(12):1205-10.

Lodha R, Kabra SK. Recurrent/persistent pneumonia. Ind Pediatr. 2000 Oct;37(10):1085-92.

Kee Ai-Rene. Paraganglioma. Am J Surg Pathol. 2003;27:1380-5.

Alasaly K, Muller N, Ostrow DN, Champion P, FitzGerald JM. Cryptogenic organizing pneumonia. A report of 25 cases and a review of the literature. Medicine. 1995 Jul;74(4):201-11.

Moessinger AC, Santiago A, Paneth NS, Rey HR, Blanc WA, Jr JM. Time‐trends in necropsy prevalence and birth prevalence of lung hypoplasia. Paediatric and perinatal epidemiology. 1989 Oct;3(4):421-31.