Causes of chronic cough in children

There are many causes of chronic cough in children.

Causes of chronic cough in children include:

• protracted bacterial bronchitis—most likely cause of an isolated chronic productive (wet or moist) cough in the absence of indicators to suggest an alternate cause
• asthma—consider if wheeze, shortness of breath and night cough are present
• environmental exposure to cigarette smoke—smoke is a significant trigger for cough. Parent or carer smoking cessation reduces cough in children
• postviral cough—following an acute viral respiratory tract infection, such as acute rhinosinusitis or acute bronchitis; cough may last up to 8 weeks
• upper airway cough syndrome (previously called postnasal drip)—consider if the child has acute rhinitis (see here)
• retained inhaled foreign body—if the cough was sudden in onset, particularly if cough started while the child was eating or playing with small objects; urgently refer to a paediatrician, an ear, nose and throat specialist, or a respiratory specialist
• infections including pertussis (whooping cough), lung abscess or tuberculosis
• congenital airway abnormalities (eg tracheomalacia, vascular ring)
• chronic lung disease (eg bronchiectasis, cystic fibrosis)—consider if recurrent episodes of protracted productive (wet or moist) cough, clubbing of the fingers, chest wall deformity, or abnormal growth or development are observed
• somatic cough syndrome (previously known as psychogenic cough)—if child presents with a bizarre honking cough; exclude other causes of cough (eg tic cough)
• tic cough (previously known as habit cough)—if child presents with a cough associated with suppressibility, distractibility, suggestibility and variability; cough may be isolated or occur in the context of other tics.

Also consider causes of acute cough because children may present late after onset of cough.