By vgreene, 2 October, 2020 Consider COVID-19 (wet or dry cough), flu in season. ✓hx/ex, incl smoking, exposures, travel, ✓red flags (hemoptysis, SOB, systemic sx, etc),1 r/o life-threatening dz (pneumonia, etc).1 ✓impact on life. F/U all pts in 4-6wk1
By vgreene, 2 October, 2020 If postnasal drip/upper airway cough syndrome suspected (eg, from rhinosinus dz), tx involves 1st-gen6 antihistamine + decongestant1
By vgreene, 2 October, 2020 If NAEB suspected (steroid-responsive cough in nonsmoker w/o airway hyperresponsiveness):5 ✓blood/sputum eos, FENO, per ACCP; per ERS, sputum eos superior to blood; FENO threshold unclear.6 Tx w/ inhaled steroids5
By vgreene, 2 October, 2020 If asthma suspected (incl cough-variant, exercise-induced), ✓spirometry pre/post-BD, methacholine challenge.1,5 Tx asthma per step tx; pre-tx exercise-induced bronchospasm w/ bronchodilators
By vgreene, 2 October, 2020 If hx obstructive airway dz: Consider asthma exac, COPD exac or acute exac chronic bronchitis. If hx bronchiectasis, consider acute exac, tx w/ airway clearance techniques, etc4
By vgreene, 2 October, 2020 If immunocompromised, ✓CXR; if (-) & common cough causes excluded, test for dz assoc w/ immunocompromise3
By vgreene, 2 October, 2020 Consider environmental exposures (resp irritants, pollutants, smoke, allergens, etc)1
By vgreene, 2 October, 2020 Consider COVID-19 (wet or dry cough), flu in season. ✓hx/ex, incl triggers, (smoking; new drug, eg, ACEI), environment1 (incl in athletes2), occupation, travel, ✓red flags (hemoptysis, dyspnea, etc),1 r/o life-threatening dz (severe COPD/ast
By vgreene, 2 October, 2020 If URI/common cold, most recover in 7-10 days. Weigh risk/benefit of sx relief, given lack of evidence.2 Abx only for confirmed strep throat2,3
By vgreene, 2 October, 2020 If pertussis strongly suspected based on clinical picture (less severe, typical “whoop” less freq in adolescents/adults), strongly consider tx awaiting test results8
