What is chronic cough in children?

Abstract

The cough reflex is modulated throughout growth and development. Cough—but not expiration reflex—appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient toward specific etiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, pediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.

Impact of Air Pollution on Age and Gender Related Increase in Cough Reflex Sensitivity of Healthy Children in Slovakia

“…Numerous studies show that physiology, physiopathology and outcome measures of cough differ in many ways throughout childhood (Thach, 2001 ; Ioan et al, 2014 ), between children and adults (Chang, 2005 , 2010 ), as well as between males and females (Fujimura, 1996 ; Fujimura et al, 1996 ; Dicpinigaitis and Rauf, 1998 ; Dicpinigaitis et al, 2001 ; French et al, 2004 ; Birring and Pavord, 2009 ; Kelsall et al, 2009 ; Lamprecht et al, 2013 ).…”

Review shows paediatric protracted bacterial bronchitis needs an accurate diagnosis and strictly targeted extended antibiotics

“…There are many rare conditions that belong to the differential diagnosis of PBB and these include missed foreign body aspirations, cystic fibrosis, primary ciliary dysfunctions, anomalies of large vessels, such as the aortic ring and innominate artery, and airway, oesophageal and pulmonary anomalies . The nature of coughs varies and usually other findings, such as systemic symptoms or respiratory distress, are present.…”

“…This means that the specific cough pointers presented in Table should raise the suspicion of an illness other than PBB. Certain specific infections, such as those caused by Bordetella pertussis , Mycoplasma pneumoniae and Chlamydia pneumoniae , may present with a prolonged cough . These coughs are not usually wet or productive, although they can continue for many weeks.…”

Down-Regulation of Cough during Exercise Is Less Frequent in Healthy Children than Adults. Role of the Development and/or Atopy?

“…The symptom assessment however is subjective and may be biased by parental perception (Dales et al, 1997; Ioan et al, 2014). Diagnostic of the respiratory condition may benefit identification of a particular trigger such as exercise that is indeed sought by cough questionnaire studies (Suguikawa et al, 2009; Cichalewski et al, 2015; Boulet et al, 2017).…”