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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Synonyms and keywords: Cough in kids

Overview

Historical Perspective

  • The word Cough was first derived from the middle English Coughen or old English Cohhian which was primarily composed of the middle Dutch Kochen and the high middle German Kuchen, in early 14th century.

Classification

  • Cough in children may be classified or defined according to the duration of presenting complaints, quality and sound, causes of cough into several groups.[1]:
  • 1 Duration of Presenting complaints: According to the duration of cough, it can be sub classified into three categories.
    • Acute: Cough persists for less than three weeks.
    • Subacute: Cough persists for three to eight weeks.
    • Chronic: Cough persists for more than eight weeks.
  • 2. Quality and sounds: According to the quality and sound cough can be sub classified in to following categories-
    • Dry or Hacking or Nonproductive.
    • Wet or productive cough.
    • Staccato or short repetitive cough.
    • Whooping or paroxysmal violent or spasmodic cough.
    • Barking cough: Brassy barking or Honking barking.
    • Phlegmy cough.
    • Burning cough.
  • 3. Causes of Cough: Based on causes cough is subdivided into following three sub groups-
    • Normal or expected cough.
    • Specific cough.
    • Non-specific cough.
  • 4. Anatomic classification on causes of cough: Cough can be produced from different anatomical locations. for example-
    • Nose and Paranasal sinuses.
    • Pharynx.
    • Larynx.
    • Trachea and Bronchi.
    • Pulmonary parenchyma.
    • Pleura.
    • Mediastinum.
    • Heart and blood vessels.
    • External ear and Tympanic membrane.
    • Esophagus.
  • 5. Grades of cough: Cough can be graded into four main sub categories-[2]
    • Eutussia or Normal.
    • Hypertussia or Sensitized.
    • Hypotussia or Desensitized.
    • Dystussia or Pathological.
    • Atussia or Absent.

Cough in children can also be classified under infectious (Bacterial, Viral, fungal, Parasitic) or non-infectous categories broadly.

Pathophysiology

  • Cough is natural innate primitive reflex that helps in mucocilliary clearance of foreign particles and secretions from respiratory tracts. It is also a defensive mechanism protecting respiratory airways from aspiration of pathogens, particulates and secretions. A complex arc comprised of neuro-respiratory pathways helps in initiating the cough reflex.[3]
 
 
 
Mechanical and chemical stimulation of cough receptors (Rapidly adapting receptors, slowly adapting receptors or C-fibers) in Respiratory airways
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Afferent pathways: Sensory nerve fibers via Vagus Nerve from ciliated columnar epithelium of upper airways, cardiac and esophageal branches from diaphragm send impulse to central cough center
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Central cough center in upper brain stem medulla and pons send impulse of sequence of phases (Inspiratory, Compressive, Expiratory) for constituting cough
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Efferent pathways: The nucleus retroambigualis sends impulse via phrenic and spinal motor nerves to diaphragm and abdominal and respiratory muscles, the nucleus ambiguous sends impulse to larynx by laryngeal branches of vagus nerve
 
 
 
  • On gross pathology, Bloody, Serous , Mucoid, Rusty, Pink frothy, and Purulent are characteristic findings of sputum produced by coughing.
  • On microscopic histopathological analysis, Pathogens, RBCs, Leukocytes, epithelial celss are characteristic findings of Sputum produced by coughing.

Causes

Causes of cough in children according to duration[4][5][6]:

 
 
 
 
 
 
 
 
Cough
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acute(<3 weeks) •Common Cold
Allergic Rhinitis
Bronchitis
Bronchiolitis
Asthma
Whooping Cough
Influenza
Croup or Tracheolaryngobronchitis
Pneumonia
Irritation by smoking
Foreign Body
GERD
 
 
 
 
Subacute(3-8 weeks) •Whooping Cough or Pertussis
•Post infectious Cough
Bacterial Sinusitis
Asthma
 
 
 
 
Chronic(>8 weeks) •Upper Airway Cough Syndrome
Asthma
Bronchiectasis in Cystic fibrosis and Kartagener Syndrome
Chronic sinusitis
Malacia
•Foreign Body
Nonasthmatic eosinophilic bronchitis
•Respiratory environmental toxins

According to quality and sound of cough in children, the causes can be classified according to following chart.

 
 
 
 
 
 
 
 
 
 
 
 
Dry or Hacking or Nonproductive
 
Sinusitis, Tonsillitis, Pharyngitis, Allergic Rhinitis, GERD, Asthma, Environmental exposure to irritants(pollen, dust, mites, smokes), Post infectious cough.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Wet or productive cough
 
Cystic fibrosis, Bronchiectasis, Bronchiolitis, Tuberculosis, Rhinitis, Postnasal drip, Pneumonia, Emphysema, Acute bronchitis, Asthma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Causes of Cough based on quality and sound
 
 
 
 
Staccato or short repetitive cough
 
Chlamydia pneumonia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Whooping or paroxysmal violent or spasmodic cough
 
Pertussis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Barking cough
 
Brassy barking: Croup, Tracheomalacia, Laryngitis, Tracheitis
Honking barking: Psychogenic cough , Tourette syndrome (habit cough)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Phlegmy cough
 
Viral infection
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Burning cough
 
Bacterial Bronchitis, Irritants
 
 
 
 
 
 

Based on anatomical location the causes of cough in children can be demonstrated into following chart-

 
 
 
 
 
 
 
 
 
 
 
 
Nose and Paranasal sinuses
 
Rhinitis, Foreign Body, Sinusitis, Nasal polyp, ppHypertrophied inferior turbinate]]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pharynx
 
Pharyngitis, Foreign Body, Irritants
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Larynx
 
Laryngitis, Epiglottis, Tonsillitis, Laryngomalacia, Subglottic stenosis, Foreign body
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Trachea and Bronchi
 
Tracheitis, Croup, Bronchiolitis, Bronchiectasis, Bronchitis, Cystic fibrosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Causes based on anatomic location
 
 
 
 
Pulmonary parenchyma
 
Pneumonia, Tuberculosis, Environmental toxin, Respiratory distress syndrome, Aspiration syndrome, Hypersensitivity Pneumonitis, Connective tissue disease, Alveolar capillary dysplasia, Neuroendocrine cell hyperplasia of infancy, Medications, Mutations causing surfactant dysfunction, Emphysema
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pleura
 
Pleurisy, Pneumothorax, Hemothorax, Parapneumonic effusions, Pleural tuberculosis, Congenital hydrothorax and chylothorax
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mediastinum
 
Mediastinitis, Mediastinal Tuberculosis, Thymoma, Thymic hyperplasia, Thymic carcinoma, Neuroblastoma, Ganglioneuroma, Non Hodgkin lymphoma, Sarcoma, Mature teratoma, Endodermal sinus tumor, Hemangioma, Wilms tumor, Lymphangioma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Heart and blood vessels
 
Congenital heart disease, Valvular heart disease, Heart failure, Myocarditis, Cardiomyopathies, Wegener granulomatosis, Vasculitis, Arteriovenous malformation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
External ear and Tympanic membrane
 
Otitis media and externa, Impaction of foreign body, wax, Myringitis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Esophagus
 
GERD, Tracheoesophageal Fistula
 
 
 
 
 
 

Differentiating Cough from other Diseases

For the differential diagnosis of productive cough, click here.
For the differential diagnosis of acute cough, click here.
For the differential diagnosis of chronic cough, click here.
For the differential diagnosis of cough and hemoptysis, click here.
For the differential diagnosis of cough and weight loss, click here.
For the differential diagnosis of cough and fever, click here.
For the differential diagnosis of cough and wheeze, click here.
For the differential diagnosis of cough, fever, and hemoptysis, click here.
For the differential diagnosis of cough, fever, and weight loss, click here.
For the differential diagnosis of cough, hemoptysis, and weight loss, click here.

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Upper airway diseases Epiglottitis[7][8] Abrupt or acute
  • 12−24 hours
+ +
  • Elevated white blood count in CBC
  • Blood culture may show bacterial growth
  • Epiglottal culture in intubated patients may show bacterial growth
  • Normal function
Croup[9] Acute
  • 3−5 days
+ + +
  • Clinical diagnosis.
  • Laboratory findings and imaging are not necessary for diagnosis
Pertussis[10][11] Acute
  • Two weeks
+ Whooping sound + + +
  • Clear chest
  • Normal function
  • Culture
Laryngopharyngeal reflux[12][13] Chronic
  • Variable
+ +
  • Normal function
  • 24 hour−dual sensor pH probe
Common Cold[14] Acute
  • 3−10 days
+ +
  • Bacterial culture is not indicated
  • Normal function
  • Clinical diagnosis
Seasonal Influenza [15] Acute
  • 5−10 days
+ +
  • Normal function
  • Clinical diagnosis
Rhinosinusitis[16][17] Acute, subacute, chronic, recurrent
  • Acute: Less than 4 weeks
  • Subacute: 4−12 weeks
  • Chronic: More than 12 weeks
  • Recurrent: 4 or more episodes or acute rhinosinusitis per year
+ + +
  • Clear chest
  • Air−fluid level, mucosal edema and bony erosion of sinus on CT
  • MRI for distinguish the etiology
  • Normal function
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Lower airway Asthma[18] Chronic
  • Years
+ Clear mucoid or yellow sputum +
  • Family history
  • Seasonal variation
Acute Bronchitis[19] Acute
  • From 5 days to 1 or 3 weeks
+ +/− +
  • FEV1 < 80%
  • Clinical diagnosis
Chronic Bronchitis[20][21] Chronic
  • Most of the days for three months in the las two years.
+ Clear sputum + +
Non−asthmatic eosinophilic bronchitis[22][23] Chronic
  • More than 8 weeks
+ Eosinophilic sputum +
  • Exposure to an occupational cause
Bronchiectasis[24] Chronic
  • Months to years
+ Mucopurulent sputum + +
  • CT of chest
Emphysema [25] Chronic
  • Months to years
+ Mucoid or purulent sputum + +
  • Exposure of tobacco and air pollution
Foreing body aspiration[26][27][28] Acute
  • Variable
+ + + +
  • No specific tests
  • Not specific
  • In children <1 year and adults >75 years
  • Organic materials in children
  • Inorganic materials in adults
Bronchiolitis[29][30] Acute
  • 8−15 days
+ + +
  • Clinical diagnosis
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Parenchyma Pneumonia[31][32] Acute
  • Variable
+ Mucopurulent sputum + +
  • Not specific
Pneumoconioses[33][34] Acute, Chronic
  • Years
+ + +
Lung cancer[35][36] Chronic
  • Years
+ + + +/− + The following investigations may be helpful:
  • Not specific
Interstitial lung disease[37][38] Chronic
  • Variable
+ + + The following investigations may be helpful:
  • Lung biopsy when lab, imaging, and PFT has indeterminate result
Tuberculosis (TB)[39][40] Chronic
  • More than 2 or 3 weeks
+ + + + +
Cystic fibrosis (CF)[41][42] Chronic
  • Variable
+ + +/− +
  • Evidence of CFTR dysfunction
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Cardiac Cardiogenic pulmonary edema[43][44] Acute
  • Days to weeks
+ Pink frothy, liquid + + The following investigations may be helpful:
  • Not specific
  • Clinical diagnosis
  • Tests are supportive
Mitral Stenosis[45][46] Chronic
  • Variable
+ Pink frothy + +
  • Not specifc
Pulmonary hypertension[47][48] Chronic
  • More than 2 years
+ + + The following investigations may be helpful:
Gastrointestinal Gastroesophageal reflux[49][50] Chronic
  • Variable
+ + +
  • Not specific
  • Normal function
  • PH testing
−−
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Autoimmune Goodpasture syndrome[51][52] Chronic
  • Variable
+ + The following investigations may be helpful:
  • Pulmonary infiltratation in chest X−Ray
  • CT scan for parenchymal involvement
Wegener's disease (GPA) [53][54] Chronic
  • Months
+ + + + + The following investigations may be helpful:
Sarcoidosis[55][56] Chronic
  • Years
+ + + The following investigations may be helpful:
Microscopic polyangitis (MPA)[57] Chronic
  • Variable
+ + + + + The following investigations may be helpful:
Churg−Strauss[58][59] Chronic
  • Variable
+ + + + +
  • Infiltrates in chest X−Ray
  • Ground glass opacities, tree−in−bud sign and small nodules in chest CT
Medication ACE inhibitors[60][61] Acute (depend on the medication)
  • From 2 weeks to 6 months
+
  • Not indicated
  • No indicated
  • Normal function
  • Clinical diagnosis
  • Resolves in four to five days of stopping the medication
  • Angioedema

Epidemiology and Demographics

  • Cough is one of the most common symptoms of children in outpatient department.
  • Ninety percent of acute cough in children is resolved within three weeks. The prevalence of Chronic Cough in children is approximately 5% to 10% in USA according to American Academy of Pediatrics.

Age

  • Cough is more commonly observed among children under 5 years of age.[62]

Gender

  • Boys are more commonly affected with cough than girls.[63]

Race

  • There are racial predilection for certain causes of Cough in children. Asthma is predominant in Blacks and American Indians or Alaska native while Cystic fibrosis, Wegener's granulomatosis are more frequently affecting Caucasians according to American Lung Association.

Risk Factors

  • Common risk factors in the development of Cough in children are-
    • Preterm Birth and delivery by caesarian section.
    • Respiratory Distress Syndrome.
    • Congenital Heart Disease.
    • Age less than 1 year.
    • Maternal Influenza vaccination.
    • Malnutrition.
    • Secondary exposure to tobacco smoke.
    • Air pollutants, Mold, Inadequate ventilation.
    • Immunodeficiencies.
    • Daycare attendance.
    • History of Atopy.
    • Household pets.
    • Low socioeconomic status.

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

  1. Alsubaie H, Al-Shamrani A, Alharbi AS, Alhaider S (March 2015). "Clinical practice guidelines: Approach to cough in children: The official statement endorsed by the Saudi Pediatric Pulmonology Association (SPPA)". Int J Pediatr Adolesc Med. 2 (1): 38–43. doi:10.1016/j.ijpam.2015.03.001. PMID 30805435.
  2. Chung KF, Bolser D, Davenport P, Fontana G, Morice A, Widdicombe J (April 2009). "Semantics and types of cough". Pulm Pharmacol Ther. 22 (2): 139–42. doi:10.1016/j.pupt.2008.12.008. PMID 19136069.
  3. Polverino M, Polverino F, Fasolino M, Andò F, Alfieri A, De Blasio F (June 2012). "Anatomy and neuro-pathophysiology of the cough reflex arc". Multidiscip Respir Med. 7 (1): 5. doi:10.1186/2049-6958-7-5. PMID 22958367.
  4. "Acute cough in children".
  5. Kwon NH, Oh MJ, Min TH, Lee BJ, Choi DC (May 2006). "Causes and clinical features of subacute cough". Chest. 129 (5): 1142–7. doi:10.1378/chest.129.5.1142. PMID 16685003.
  6. Bergamini M, Kantar A, Cutrera R, Interest Group I (2017). "Analysis of the Literature on Chronic Cough in Children". Open Respir Med J. 11: 1–9. doi:10.2174/1874306401711010001. PMID 28553418. Vancouver style error: initials (help)
  7. Stroud RH, Friedman NR (2001). "An update on inflammatory disorders of the pediatric airway: epiglottitis, croup, and tracheitis". Am J Otolaryngol. 22 (4): 268–75. doi:10.1053/ajot.2001.24825. PMID 11464324.
  8. Solomon P, Weisbrod M, Irish JC, Gullane PJ (1998). "Adult epiglottitis: the Toronto Hospital experience". J Otolaryngol. 27 (6): 332–6. PMID 9857318.
  9. Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
  10. Bellamy EA, Johnston ID, Wilson AG (1987). "The chest radiograph in whooping cough". Clin Radiol. 38 (1): 39–43. PMID 3816065.
  11. "Pertussis | Whooping Cough | Clinical | Information | CDC".
  12. "What is LPR? | American Academy of Otolaryngology-Head and Neck Surgery".
  13. Noordzij JP, Khidr A, Desper E, Meek RB, Reibel JF, Levine PA (2002). "Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis". Laryngoscope. 112 (12): 2192–5. doi:10.1097/00005537-200212000-00013. PMID 12461340.
  14. Eccles R (2005). "Understanding the symptoms of the common cold and influenza". Lancet Infect Dis. 5 (11): 718–25. doi:10.1016/S1473-3099(05)70270-X. PMID 16253889.
  15. Kim EA, Lee KS, Primack SL, Yoon HK, Byun HS, Kim TS, Suh GY, Kwon OJ, Han J (2002). "Viral pneumonias in adults: radiologic and pathologic findings". Radiographics. 22 Spec No: S137–49. doi:10.1148/radiographics.22.suppl_1.g02oc15s137. PMID 12376607.
  16. Meltzer EO, Hamilos DL (2011). "Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines". Mayo Clin Proc. 86 (5): 427–43. doi:10.4065/mcp.2010.0392. PMC 3084646. PMID 21490181.
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