Over the centuries, knowledge of the anatomy and mechanisms underlying symptoms and signs has been gathered and related to the observed patterns of classical respiratory illnesses. History-taking is justified based on its high diagnostic yield, which guides subsequent diagnostic or therapeutic approaches ( 4, 5). These guidelines consist of a thorough history, physical examination, chest radiography, and spirometry ( 3). These guidelines have proven efficacious in improving the quality of life and achieving cough resolution earlier (compared to that in controls) in children presenting to specialist clinics ( 1) and in those presenting with acute cough who then developed chronic cough ( 2). Thus, guidelines for evaluating chronic cough in children have been developed to help healthcare practitioners. Since the underlying pathology can indicate either a benign or more severe condition, an accurate and efficient diagnosis is required to identify effective treatments. In the present article, we outline the major questions comprising a detailed history taking for chronic cough in children.Ĭoughing in children is one of the most common symptoms primarily resulting from respiratory tract disorders, but may also be associated with a variety of extra-pulmonary causes. While studies have described evidence-based red flags in children with chronic cough, the value of skilled physicians regarding history taking has received less attention for the best patient care. Detailed history taking enhances the evaluation and treatment, and facilitates a tailored diagnostic identification of likely diagnoses. Thus, taking accurate respiratory history for coughing helps delineate the pathophysiological basis of the cause of chronic cough. Guidelines for managing chronic cough in children are based on recording the history, followed by physical examination, chest radiography, and spirometry. Chronic cough in children differs from that in adults with respect to its etiologies and management since it can indicate a symptom of an underlying disease in children. 11Child Health Division, Menzies School of Health Research, Darwin, NT, AustraliaĬhronic cough is a common symptom of many underlying respiratory and non-respiratory disorders and may be associated with less serious causes, such as gastroesophageal reflux and nasal diseases.10Division of Respiratory Medicine and Childhood Research Center, University Children's Hospital Zurich, Zurich, Switzerland.9Department of Pediatrics, Adolescent Medicine, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Klinikum Ottakring, Vienna, Austria.8Primary Cilia Dyskinesia Unit, School of Medicine, University of Thessaly, Larisa, Greece.7Royal Belfast Hospital for Sick Children, Belfast, United Kingdom.6Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom.5Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.4Center for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.3Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, QLD, Australia.2Department of Paediatrics, University Vita Salute San Raffaele, Milano, Italy.1Paediatric Asthma and Cough Centre, Gruppo Ospedaliero San Donato, Bergamo, Italy.Shields 6,7, Grigorios Chatziparasidis 8, Angela Zacharasiewicz 9, Alexander Moeller 10 and Anne B. Marchant 3,4 †, Woo-Jung Song 5, Michael D.
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