A coughing child: could it be asthma?

BACKGROUND

A child presenting with cough is common in general practice. Usually the cough is due to an upper respiratory tract infection, however, parents are often concerned that the cough may be asthma.

OBJECTIVE

This article focusses on identifying various causes of persistent cough, especially asthma.

DISCUSSION

Significant causes of an acute cough need to be considered such as inhaled foreign bodies, aspiration, infections such as pertussis and pneumonia, and asthma. Clinical history, followed by physical examination and consideration of special investigations will guide the diagnosis. Cough as the sole symptom of asthma is unusual. There is usually associated wheeze and shortness of breath. A family or personal history of atopic symptoms lend weight to the possibility of asthma. In children with asthma, physical examination and even spirometry may be normal between episodes. In some cases where asthma is suspected, a trial of bronchodilation with formal assessment of response may be appropriate.