By vgreene, 23 September, 2020 If eval negative: Watch, wait, re-eval in 2wk, per ACCP1 (up to 4wk, per ERS2), then follow to resolution1
By vgreene, 23 September, 2020 Consider DDx.1 Nonspecific dry cough usually postviral cough or acute bronchitis. Test for pertussis if suspected3 (posttussive vomit, paroxysms, inspiratory whoop).1 Don’t routinely allergy test w/o s/sx allergies,2 though may be useful if dx uncertain o
By vgreene, 23 September, 2020 If no asthma/reversible airway obstruction, consider pedi pulm consult and/or eval2 for underlying dz:1
By vgreene, 23 September, 2020 Therapy for somatic cough disorder11,12 (aka, habit/tic/psychogenic) lacks evidence in children.2 Reassurance, psychotherapy, counseling, suggestion tx, hypnosis, etc, have been suggested2
By vgreene, 23 September, 2020 Don’t use OTC cough meds (in young children, per AAP,7 FDA8), d/t adverse event risk, insufficient evidence of benefit;1 no proven benefit in pts
By vgreene, 23 September, 2020 Don’t empirically tx UACS/postnasal drip from sinus dz (controversial pedi cause), GERD (rare pedi cause5), or asthma unless clinical features beyond cough present.1 Set time limit on tx trials.1 Post-acute viral bronchiolitis cough: Don’t use asthma drug
By vgreene, 23 September, 2020 Don’t routinely allergy test w/o s/sx allergies;1,2 however, testing may be useful if dx uncertain or for allergy mgmt, per AAO4
By vgreene, 23 September, 2020 Test for pertussis if suspected (posttussive vomit, paroxysms, inspiratory whoop)3
By vgreene, 23 September, 2020 DDx: Post-viral URI most common; sequential viral URIs may occur. Consider bronchiectasis, TB/mycosis/other infxn, immunodeficiency, aspiration, interstitial lung dz, abnl airway, cardiac dz, drug effect, habit/tic, etc1
By vgreene, 23 September, 2020 If asthma/reversible airway obstruction, re-eval in 2-4wk for persistence.1 Wheeze shouldn’t r/o pertussis3 (test if suspected). At re-eval:
