Include serious causes (e.g., pneumothorax, pulmonary embolism [PE]) in the differential diagnosis.
Diagnose a viral infection clinically, principally by taking an appropriate history.
Do not treat viral infections with antibiotics. (Consider antiviral therapy if appropriate.)
In pediatric patients with a persistent (or recurrent) cough, generate a broad differential diagnosis (e.g., gastroesophageal reflux disease [GERD], asthma, rhinitis, presence of a foreign body, pertussis).
In patients with a persistent (e.g., for weeks) cough:
Consider non-pulmonary causes (e.g., GERD, congestive heart failure, rhinitis), as well as other serious causes (e.g., cancer, PE) in the differential diagnosis. (Do not assume that the child has viral bronchitis).
Investigate appropriately.
Do not ascribe a persistent cough to an adverse drug effect (e.g., from an angiotensin-converting enzyme inhibitor) without first considering other causes.
In smokers with persistent cough, assess for chronic bronchitis (chronic obstructive pulmonary disease) and make a positive diagnosis when it is present. (Do not just diagnose a smoker’s cough.)
General Overview
Acute <3w
Subacute 3-8w
Chronic >8w
Cough
Common
Post infectious (URTI/pneumonia/sinusitis/bronchitis)