Causes of acute cough in children

The most common cause of acute cough in children is acute viral respiratory tract infection. Acute cough can be productive (wet or moist) or dry, and symptoms settle spontaneously in 7 to 10 days; 90% of affected children are cough-free within 3 weeks.

Suspect acute bacterial pneumonia in children with acute cough who have persistent fever, increased effort of breathing, and tachypnoea at rest. Children with bacterial pneumonia are lethargic and appear unwell.

Suspect inhaled foreign body if cough is sudden in onset, particularly if cough started while the child was eating or playing with small objects. Wheeze may also be present; urgently refer infants or children in whom there is clinical suspicion of foreign body aspiration.

Consider croup in children with a barking or brassy acute cough.

Also consider causes of chronic cough because children may present soon after onset of cough.