Cough is a sudden reflex action that occurs to clear the breathing passage way of irritants or secretions.
It is worthy of note that coughing is actually a protective mechanism of the body. It’s a forceful expiratory effort required to dislodge and or expel an irritant.
Cough is a common childhood symptom.
There are several causes of cough in children which are not unlike the causes in an adults. However, its morbidity is of higher consequence in children because of their narrower airways and relatively lower immunity.
Types of cough: can be grouped as.
1. Dry/productive cough– usually due to infections of the upper respiratory tract(nose and throat)eg. cold, influenza, external irritants like smoke or asthma (as an early sign).
2. Wet/ productive cough– usually due to fluid or serration in the lower respiratory tract caused by infection or asthma. When the expellant is
• mucoid, clear and tough…..it could be asthma.
• purulent, thick and yellowish…..it could be pneumonia, bronchiectasis.
• frothy or blood stained….suspect pulmonary oedema.
• bloody….suspect pulmonary tuberculosis, bronchiectasis.
Character of cough:
• Barky (like a sea lion) also known as Croup. Usually due to swelling of the wind pipe. Viral infections commonly implicated are parainfluenza or influenza virus.
• Paroxysmal (persistent bouts) seen in foreign body aspiration, asthma, diphtheria, pertussis which also has a terminal whoop after bouts (whooping cough).
• Brassy shows tracheal involvement.
Onset/ duration of cough:
• .Acute. Less than 3 weeks.
• . Chronic…more than 3weeks.
• .Sudden….usually associated with forced feeding when child aspirates.
Cough may be associated with
• .Fever…suggests presence of an infection.
• .Preceding catarrh..indicates a downward extension of upper respiratory tract infection.
• .Post-tussive vomiting…as seen in pertussis.
• .Drooling/refusal of feeds….as seen in tonsillitis
• .Weight loss, night sweat…as seen in Pulmonary tuberculosis.
• .Change in breathing.
• .Chest pain…associated with pneumonia, pluritis, bronchitis.