Pulmonary Causes of chronic Cough in Children

1. Pulmonary Causes of Chronic Cough in
Children

2. Pulmonary Causes
Primary Cause Risk factors or mechanism Major evaluation method
Inhaled retained foreign body Young child, history of choking Bronchoscopy
Interstitial lung Disease Primary genetic abnormality,
Post severe infection bronchiolitis
obliterans,
Autoimmune disease,
Radiation,
Drugs
Relevant genetic or autoimmune
test or lung biopsy
Mechanical inefficiency Tracheo bronchomalacia and other
airway anomalies,
Vascular rings or other anomalis
that cause tracheal narrowing
Dynamic bronchoscopy, chest CT
with contrast,
Chest MRI (if vascular cause
suspected)
Noninfective bronchits Exposure to environmental
pollutants ( eg. Tobacco, Smoke,
Fungai, Traffic)
History and removal of trigger
Post infection ( self resolving) Viral infection Pertussis, Para
pertuissis
PCR/ serology
Space occupying lesions Cyst and Tumor Chest CT and MRI scan

3. Pulmonary causes
Primary Cause Risk factors or mechanism Major evaluation method
Aspiration (recurrent small volume) Primary swallowing dysfunction or laryngeal disorder,
GER achalasia cardia
Swallowing assessment (eg. Video fluoroscopic test
and other evolution
Asthma, cough-dominant asthma Genetics environment, atopy , post acute respiratory
infections
Lung function test, airway hyper responsiveness test
Chronic endobronchial suppurative disease
(Protracted bacterial bronchitis, chronic suppurative
lung disease, bronchiectasis
Cystic fibrosis,
Immunodeficiency (Primary/secondary),
Primary ciliary dyskinesia
Sweat test, genetic screening
Evaluation of immune function, Cilia biopsy
Chronic pneumonia Chronic atelectasis, mucus plugging, pathogens
include tuberculosis non tuberculosis mycobacteria,
mycoplasma fungi and chlamydia
Chest CT , Bronchoscopy,
Relevant microbial assessment (eg. QuantiFERON
gold and Gene Xpert for tuberculosis
Eosinophilic lung disease Primary or secondary (ie., related to parasitic disease ) Bloods and bronchoalveolar lavage

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