Materiały źródłowe

• #1 Cough: Causes, Diagnosis, Treatment & Conditions

  https://my.clevelandclinic.org/health/symptoms/17755-cough

  A cough is a reflex reaction designed to keep your airways clear. […] Your healthcare provider can help you figure out whats going on. […] A cough is a natural reflex that is your bodys way of removing irritants from your upper (throat) and lower (lungs) airways. A cough helps your body heal and protect itself. […] Anyone can get a cough. A cough is the most common symptom reported in healthcare providers’ offices. […] In general, call your healthcare provider if you have a cough that will not go away and these symptoms: Wheezing (noise when you breathe out). […] To diagnose whats behind your cough, your healthcare provider will take a medical history, give you a physical exam, and may order some tests. […] Cough is a symptom of COVID-19. It can also be part of a post-COVID syndrome (or long COVID). […] If you also have other symptoms like trouble breathing, fever, trouble eating or sleeping, or youre coughing up bloody or colored sputum, call your healthcare provider for advice.

• #1 Cough: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0215/p567.html

  On a typical day, a family physician will see at least one patient presenting with cough. Cough can be divided into three categories: acute (i.e., lasting less than three weeks), subacute (i.e., lasting three to eight weeks), and chronic (i.e., lasting longer than eight weeks). […] The first step in diagnosing subacute cough is to determine whether the cough has followed a respiratory infection. If the cough does not appear to be postinfectious, it should be managed as if it were a chronic cough. […] Chronic cough is often caused by more than one condition. […] The diagnosis should begin with a medical history, physical examination, and chest radiograph. […] If the patient has only partial resolution of cough but no signs of upper airway cough syndrome, then an evaluation for asthma should be done.

• #1 How to Diagnose and Treat a Cough

  https://www.verywellhealth.com/what-to-do-about-a-cough-770770

  There are several different types of coughs. Each has distinct characteristics that we can use to help identify its cause. […] Home treatments may be used for an uncomplicated cough, but you will need to know when to see a healthcare provider. Noting any other other symptoms you may have will be important to help them find a diagnosis. […] A cough may be described as being dry (non-productive) or wet (productive). With a wet cough, you produce mucus and/or sputum. Even the way a cough sounds can give us a pretty good clue as to what is going on. […] A chronic cough may be an indication of a condition like chronic obstructive pulmonary disease (COPD) or gastroesophageal reflux (GERD), or, in some cases, lung cancer. […] To further establish the cause of a cough, healthcare providers look at not only the cough but the accompanying symptoms as well. Together, they paint a clearer portrait of the illness.

• #1 Cough – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cough/

  A cough can be classified as acute, subacute, or chronic, in addition to productive (with sputum expectoration) or dry. […] The cause of an acute cough can often be determined clinically with a thorough medical history and physical examination. Chronic cough or the presence of red flag symptoms (including dyspnea, fever, hemoptysis, and weight loss) indicate that further investigation is required. […] Diagnostic studies for acute or subacute cough are not routinely indicated in patients without red flags for cough. […] Diagnostic evaluation depends on chronicity and the presence of red flags for cough: Acute cough and subacute cough: Diagnostic studies are not routinely indicated (unless red flags for cough are present). […] If symptoms persist despite evaluation and treatment for the most common causes: Consult or refer to a specialist, e.g., pulmonology, otolaryngology. […] Consider the following on a case-by-case basis depending on clinical evaluation for cough, duration, and results of initial investigations.

• #1 Chronic cough – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-cough/diagnosis-treatment/drc-20351580

  Your healthcare professional may ask some of these questions: What are your symptoms and when did they begin? Did you recently have the flu or a cold? Do you smoke tobacco or have you ever smoked tobacco? […] Your healthcare professional will ask more questions based on your responses, symptoms and needs. Preparing for questions will help you make the most of your time.

• #1 Cough in Adults – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/symptoms-of-pulmonary-disorders/cough-in-adults

  Cough is a protective reflex that prevents aspiration and expels particles and irritants from the airway. However, it can become uncontrolled or disabling and is one of the most common symptoms prompting physician visits. […] Likely causes of cough differ depending on whether the symptom is acute (present 8 weeks) or chronic. […] In acute cough, the most common causes are upper respiratory infection (URI), including acute bronchitis, postnasal drip, and pneumonia. […] In chronic cough, the most common causes are postnasal drip, gastroesophageal reflux, asthma, chronic bronchitis, COPD (chronic obstructive pulmonary disease), airway hyperresponsiveness after resolution of a viral or bacterial respiratory infection, and angiotensin-converting enzyme (ACE) inhibitors. […] Purely psychogenic cough is rare and is a diagnosis of exclusion. However, patients with chronic cough may develop a secondary reflex or psychogenic component to their cough.

• #1 Evaluation of the Patient with Chronic Cough | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p887.html

  Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. […] The most common causes of chronic cough in adults are upper airway cough syndrome, asthma, and gastroesophageal reflux disease, alone or in combination. […] The diagnosis of asthma should be confirmed based on clinical response to empiric therapy with inhaled bronchodilators or corticosteroids. […] Empiric treatment for gastroesophageal reflux disease should be initiated in lieu of testing for patients with chronic cough and reflux symptoms. […] In children, a cough lasting longer than four weeks is considered chronic. […] The most common causes of chronic cough in children are respiratory tract infections, asthma, and gastroesophageal reflux disease.

• #1 Evaluation of the Patient with Chronic Cough | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p887.html

  Evaluation of children with chronic cough should include chest radiography and spirometry. […] Most episodes of chronic cough in adults are caused by upper airway cough syndrome (UACS, also known as postnasal drip syndrome), asthma, or gastroesophageal reflux disease (GERD), alone or in combination. […] Chronic cough has two or more causes in 18 to 62 percent of patients, and three causes in up to 42 percent of patients. […] Empiric treatment should be initiated sequentially for the three most common causes of chronic cough until symptoms are resolved. […] The evaluation of chronic cough begins with a thorough history, including smoking status, environmental exposures, and medication use. […] Normal chest radiography usually excludes bronchiectasis, persistent pneumonia, sarcoidosis, and tuberculosis.

• #1 Chronic cough – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-cough/diagnosis-treatment/drc-20351580

  Your healthcare professional asks about your medical history and does a physical exam. A thorough medical history and physical exam can give important clues about a chronic cough. Your health professional also may order tests to look for the cause of your chronic cough. […] But many health professionals start treatment for one of the common causes of chronic cough rather than ordering expensive tests. If the treatment doesn’t work, you may be tested for less common causes. […] A chest X-ray and spirometry, at a minimum, are usually ordered to find the cause of a chronic cough in children. […] Finding out what’s causing a chronic cough is very important to effective treatment. In many cases, more than one underlying condition may be causing your chronic cough. […] Your healthcare professional works to find the cause of your cough and the best treatment for you. During that time, your healthcare professional also may prescribe a medicine to reduce coughing, called a cough suppressant. Cough suppressants are not recommended for children.

• #1 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  Although no specific history or physical exam findings are reliably associated with specific etiology of chronic cough, they may direct further testing or therapeutic trials. […] The symptoms and findings associated with the common causes (asthma, UACS, GERD, or NAEB) may direct further diagnostic evaluation toward confirming that cause. […] A chest x-ray should be obtained early in the evaluation of chronic cough. […] Although it is not diagnostic of the most common causes, findings may quickly divert the evaluation to causes of greater gravity, such as structural lung diseases. […] Following chest x-ray, the choice of either diagnostic testing or therapeutic trials depends on the clinician’s assessed probability of a specific etiology and the patient’s preferred approach. […] Unless the history, physical examination, and chest x-ray indicate otherwise, efforts should be concentrated on one or more of the four most common causes (asthma, UACS, GERD, NAEB).

• #1 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  If none of the four most common causes seem likely after thorough assessment, other tests to consider include: High-resolution CT imaging of the chest to look for bronchiectasis, foreign body aspiration, pulmonary fibrosis, or other structural lung disease. […] Therapeutic trials are selected based on clinical impression, at times supported by diagnostic testing. The patient’s response to the trial must be assessed and the cough resolved before a given etiology may be assigned with certainty. […] In this event, further testing and/or additional therapeutic trials may be indicated, while the partially successful therapy should be continued.

• #1

  https://link.springer.com/article/10.1007/s41030-019-0089-7

  There is a 92% probability, based on prospective trials, that in patients who have been treated unsuccessfully for UACS, asthma, and NAEB, not on an ACE and with a normal CXR, that their chronic cough is due to GERD. […] Spirometry is the gold standard to diagnose asthma and COPD, but false positives can exist with some conditions that can cause confusion. […] The diagnosis of GERD can be critically performed by the use of dual-channel 24-h pH probe monitoring, but this is not a first-line investigation and should be considered in those refractory to therapy. […] Chronic cough is common, disabling, and may not have a readily obvious cause. The use of an algorithmic approach such as the ACCP guidelines can give you a roadmap to making the diagnosis. It is tempting to just try ICS, but in the absence of evidence of eosinophilic inflammation, this should be avoided. Go to the effort of making a firm diagnosis, most often one of the big three of UACS, GERD, or asthma, especially in those without any red flags and your success of treatment will be much higher.

• #1 Patient education: Chronic cough in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/chronic-cough-in-adults-beyond-the-basics/print

  If asthma is suspected but cannot be confirmed, the clinician may perform lung function tests that measure the pattern of air flow into and out of the lungs. […] To confirm a diagnosis of acid reflux, a test may be done to measure the acid level of fluid in the esophagus. […] Treatment of chronic cough aims to eliminate the underlying cause. Most of the time, each type of treatment is tried separately, one after another, instead of all at the same time. […] If your cough is due to asthma, you will be given the standard treatment for asthma, which includes an inhaled glucocorticoid such as fluticasone (Flovent), budesonide (Pulmicort), or beclomethasone (QVAR). […] If, after a thorough evaluation, the cause of your cough cannot be determined and the cough persists, a medication that suppresses your cough may be recommended.

• #1 Cough: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0215/p567.html

  It has been shown that bronchoprovocation is useful in the evaluation for cough caused by asthma. […] To diagnose nonasthmatic eosinophilic bronchitis, an induced-sputum test should be performed to determine if the patient has an increased number of eosinophils. […] Any patient who responds only partially or not at all to the above therapies should be empirically treated for GERD.

• #1 Diagnosis and management of chronic cough: similarities and differences between children and adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7385707/

  Cough is considered chronic when it is present for longer than 4 weeks in children or 8 weeks in adults. […] In adults, asthma and bronchitis are well-defined etiologies of chronic cough, but much chronic cough in adults is largely a conundrum. […] Reviews of adult chronic cough report that at least 40% of adults with chronic cough have no medical explanation. […] Treatment for a specific diagnosis provides a better outcome than trials of cough suppression in the absence of a specific diagnosis. […] This article reviews etiologies and the treatment of chronic cough in children and the conundrum of diagnosing and treating chronic cough in adults. […] In contrast to the identification of chronic cough in children, chronic cough in adults often remains a conundrum. […] Since asthma, including cough-variant asthma, is a common cause of chronic cough, a course of oral prednisone can be given as a therapeutic trial for both adults and children.

• #1 Diagnosing Chronic Cough | NYU Langone Health

  https://nyulangone.org/conditions/chronic-cough-in-children/diagnosis

  Through physical exams and other tests, our pulmonologists can diagnose the cause of your child’s chronic cough. […] Our specialists can diagnose the precise cause of your child’s chronic cough. Our pulmonologists, or lung specialists, begin with a comprehensive physical exam to assess your child’s symptoms, followed by additional tests to check for bacterial infection and to rule out other possible causes. […] If needed, our pulmonologists make referrals to other specialists, such as gastroenterologists or infectious disease specialists, who can confirm and treat less common causes of chronic cough in children. […] In a sputum culture, a doctor takes a sample of your child’s mucus, if enough can be produced from coughing, to look for the presence of a bacterial infection. […] Lung function tests play a major role in identifying the cause of a chronic cough and can be performed in children as young as age 5. […] This test may be used when the cause of a chronic cough cannot be determined with a physical exam and sputum culture, or if the cough remains after treatment. […] After our doctors establish the correct diagnosis, the next step is to select the appropriate treatment for your child.

• #1 Chronic Cough: Practice Essentials, Mechanism of Cough, Causes of Chronic Cough

  https://emedicine.medscape.com/article/1048560-overview

  The hallmarks of asthma are variable airflow obstruction and airway hyperresponsiveness, which manifest as shortness of breath, wheezing, dyspnea, and cough. Cough occurs in all asthmatics, and in a subset of patients with cough-variant asthma (CVA), it is the only presenting symptom. The treatment of asthma, regardless of whether it is of the cough variant or not, includes beta-2 agonists and corticosteroids. […] The criterion standard for diagnosis of GERD is dual-channel 24-hour pH probe monitoring. Alternatively, flexible nasopharyngoscopy can reveal glottic changes associated with reflux. […] NAEB has been implicated as an etiology of chronic cough in 13-33% of patients. It is characterized by eosinophilic infiltration of the bronchial tree as well as the absence of variable airflow obstruction and airway hyperresponsiveness. This disease is highly responsive to inhaled corticosteroids.

• #1 Cough: Diagnosis, Treatment, and Support for Better Health

  https://www.lungsleephealth.com/service/cough

  A persistent cough, however, can be a sign of an underlying health condition, such as a cold, flu, asthma, or lung infection. […] It’s important to note that a cough that lasts for more than eight weeks can be a sign of an underlying health condition that requires medical attention. Diagnosis is done through a series of tests, including a physical exam, chest X-ray, pulmonary function test, and sputum test. The doctor may also order a CT scan or bronchoscopy if needed. […] The diagnosis is made based on the patient’s medical history, physical exam, and test results. […] We offer a variety of diagnostic tests to assess lung function and diagnose lung conditions. These tests include spirometry, pulmonary function tests, bronchoscopy, and chest X-rays.

• #1 Chronic Cough: Causes & Treatment

  https://my.clevelandclinic.org/health/symptoms/15048-chronic-cough-overview

  Chronic cough is a cough that lasts more than eight weeks in adults and four weeks in children. […] To diagnose chronic cough and determine its cause, a healthcare provider will perform a physical examination and ask about your symptoms. […] Treatment for chronic cough depends on the associated health condition. Your healthcare provider will discuss a tailored treatment plan based on your unique needs. […] You should schedule a visit with a healthcare provider if you have a lingering cough that wont go away. […] Chronic cough is a cough that lasts longer than eight weeks in an adult and four weeks in a child. If coughing is having a negative impact on your life, contact a healthcare provider to find the cause.

• #1 Chronic Cough: Practice Essentials, Mechanism of Cough, Causes of Chronic Cough

  https://emedicine.medscape.com/article/1048560-overview

  Only when management of the most common causes has failed to yield a resolution of cough should a more extensive workup begin. This can include induced sputum testing for acid-fast bacillus, high-resolution CT scanning of the chest, and bronchoscopy. Often, these tests should be performed by a cough specialist. If further testing does not reveal the cause, then the patient most likely has chronic cough hypersensitivity syndrome. Owing to inflammation and hyperresponsiveness of the airway from some inciting cause, tissue remodeling has occurred, leading to an enhanced cough reflex that maintains the cough even though the inciting cause has resolved. […] In the immunocompetent nonsmoking patient who does not take angiotensin-converting enzyme (ACE) inhibitors, the most common causes of chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD). Together, these causes account for more than 90% of all cases of chronic cough. Frequently more than one of these etiologies is present, and cough may be the only presentation. Nonasthmatic eosinophilic bronchitis (NAEB) should also be considered early in the diagnostic evaluation because it is easily diagnosed and treated. Only after these most common causes of chronic cough are ruled out should more extensive testing be performed, usually after referral to a cough specialist. An empiric and integrative approach that uses sequential and additive therapy is needed to systematically evaluate and effectively treat patients with chronic cough.

• #1 The spectrum, clinical features and diagnosis of chronic cough due to rare causes – Lai – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/51121/html

  Chronic cough has many diverse causes, including common and uncommon causes. […] The purpose of this study is to determine the etiological distribution, clinical features, and diagnostic value of special examinations in patients with rare causes of chronic cough. […] Causes of chronic cough with a prevalence of less than 3% were defined as rare causes. […] Among the 31 rare causes of chronic cough in this cohort, the top five were protracted bacterial bronchitis, somatic cough syndrome, diffuse panbronchiolitis, OSAS, and interstitial lung disease. […] Special examinations, such as chest HRCT and bronchoscopy, should be considered after excluding common causes of chronic cough. […] The diagnosis of rare causes depends on special examinations, such as high-resolution computed tomography (HRCT), nasopharyngoscopy, or bronchoscopy.

• #1 The spectrum, clinical features and diagnosis of chronic cough due to rare causes – Lai – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/51121/html

  This study showed that many rare causes of chronic cough were misdiagnosed as chronic bronchitis or chronic pharyngitis. […] Therefore, the diagnosis of chronic bronchitis, chronic pharyngitis or UC should be made very carefully when common causes of chronic cough are ruled out. […] Our study showed that chest HRCT resulted in high positive rates in the diagnosis of rare causes. […] Therefore, we propose that HRCT and bronchoscopy should be considered if no abnormalities are observed in routine examinations and if patients do not respond to empirical treatment. […] In conclusion, rare causes of chronic cough accounted for 13.1% of all causes of chronic cough in this cohort. […] Special examinations such as HRCT and bronchoscopy play an important role in diagnosing rare causes and should be considered based on the patients condition after excluding common causes of chronic cough.

• #1 Evaluation of the Patient with Chronic Cough | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1015/p887.html

  UACS is caused by a variety of upper respiratory conditions. […] It is the most common cause of chronic cough in nonsmoking, immunocompetent adults who have normal chest radiography. […] Diagnosis is often based on findings from the history and physical examination. […] Asthma is the next most common cause of chronic cough in adults. […] Cough is the most commonly reported symptom in patients with chronic asthma, and it is the only manifestation in up to 57 percent (i.e., cough-variant asthma). […] GERD is the third leading cause of chronic cough in adults. […] Although GERD treatment is not universally beneficial for cough associated with the disease, an empiric trial of a proton pump inhibitor is recommended. […] A diagnosis of UACS can also be made after a trial of therapy.

• #1 Diagnostic algorithm for chronic cough – Medical Independent

  https://www.medicalindependent.ie/clinical-news/diagnostic-algorithm-for-chronic-cough/

  Diagnosis is made by a focused history demonstrating variability in the above symptoms, a physical assessment, and spirometry or peak expiratory flow (PEF) test with reversibility. […] There is no agreed definitive test for asthma, therefore, clinical diagnosis relies on a thorough health history, clinical findings, and assessment of symptoms with treatment. […] A chronic iatrogenic cough is widely recognised as an adverse effect of ACE inhibitors, which are prescribed as anti-hypertensives, or for heart failure. […] GORD is a common presentation in primary care that occurs when the reflux of stomach contents causes symptoms and/or complications. […] Diagnosis of GORD is considered in the absence of exposure to environmental irritants, smoking, no ACE inhibitor, asthma, and rhino-sinus disease, and with a normal CXR.

• #1 Diagnostic algorithm for chronic cough – Medical Independent

  https://www.medicalindependent.ie/clinical-news/diagnostic-algorithm-for-chronic-cough/

  UACS describes a variety of signs and symptoms previously referred to as post-nasal drip syndrome (PNDS), rhinitis, and rhinosinusitis. […] A clinical history focused on cough characteristics and associated symptoms, combined with a physical examination, is a key part of the clinical decision-making process. […] This article outlined the pathological process and diagnostic modalities in four common causes of chronic cough in primary care.

• #1 Chronic Cough: Practice Essentials, Mechanism of Cough, Causes of Chronic Cough

  https://emedicine.medscape.com/article/1048560-overview

  Every patient with chronic cough needs a thorough history taken and physical examination performed as part of their evaluation. Each patient should also have a chest radiograph taken. […] Management should begin with cessation of smoking or angiotensin-converting enzyme (ACE) inhibitor use in those patients whose history indicates such action. Most patients have a resolution of their cough within 4 weeks of smoking cessation. Cough related to ACE inhibitor use usually subsides within 2 weeks, but the median time has been reported to be 26 days. […] UACS is considered the most common cause of chronic cough and has been implicated as the cause in up to 87% of patients. Mucoid secretions containing inflammatory mediators are thought to stimulate pharyngeal and laryngeal sites, inducing cough.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-whooping-cough.aspx

  Whooping cough or Pertussis is difficult to diagnose in the initial phases. This is because the initial signs and symptoms mimic a cold or flu or bronchitis. […] Over a week or so the features of characteristic coughing bouts with vomiting appear making diagnosing the disease clinically easier. […] Diagnosis begins with taking a detailed history of the symptoms and exposure to the disease. Physical examination follows to check on the signs and symptoms. […] There are several laboratory tests used to diagnose the condition including bacterial culture, blood tests and so forth. […] A swab is taken from the nose or throat usually during the first two weeks of the infection. Alternatively a suction sample of the mucus is taken from the throat. […] The sample is checked under the microscope for the bacteria. This is considered the gold standard for diagnosis because it gives 100% accurate results.

• #1 Unexplained chronic cough | informedhealth.org

  https://www.informedhealth.org/unexplained-chronic-cough.html

  A chronic cough is a cough that lasts for longer than eight weeks. If healthcare professionals are unable to identify the cause of the cough, its referred to as unexplained. […] If the doctor cant identify a cause, even after extensive tests and examinations, theyll diagnose you with unexplained chronic cough. This condition is also sometimes called idiopathic cough or refractory cough. […] If your symptoms are severe, they can be treated with speech or physical therapy and medication. But it isnt clear whether they can ease chronic cough or how well. […] Your family doctor can usually do the first round of tests necessary for chronic coughs. Any additional examinations need to be done by a lung specialist (a pulmonologist) or an ENT (ears, nose and throat) specialist. […] If its still not clear whats causing your chronic cough after all these examinations, it will be diagnosed as unexplained chronic cough.

• #1 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  Patients may present with a subacute cough, most commonly postinfection; however, in most patients, postinfectious cough is self-limited. […] Once the cough persists for longer than 8 weeks, further evaluation is indicated. […] Several validated tools of cough assessment are available, although these are used mostly for research purposes. […] Pursuing the cause and resolution of chronic cough requires ongoing commitment to the patient. The approach to an individual patient with chronic cough may vary from full initial diagnostic evaluation for common associated diseases, to empiric but targeted therapy for common conditions known to cause chronic cough, with limited or no diagnostic efforts. […] In practice, diagnostic and therapeutic processes are often applied simultaneously. It is best to involve the patient in choosing the best approach and to explain the expected duration and course of diagnostic and therapeutic trials.

• #1 Identifying unique spectral fingerprints in cough sounds for diagnosing respiratory ailments | Scientific Reports

  https://www.nature.com/articles/s41598-023-50371-2

  Coughing, a prevalent symptom of many illnesses, including COVID-19, has led researchers to explore the potential of cough sound signals for cost-effective disease diagnosis. […] Our study examined cough sounds from 1183 COVID-19-positive patients and compared them with 341 non-COVID-19 cough samples, as well as analyzing distinctions between pneumonia and asthma-related coughs. […] The identification of these acoustic signatures in cough sounds holds the potential to transform the classification and diagnosis of respiratory diseases, offering an affordable and widely accessible healthcare tool. […] Our research delves into the physics and acoustics of cough sound signals, aiming to map these signals to their corresponding respiratory diseases and explore coughing as a potential biomarker.

• #1 Identifying unique spectral fingerprints in cough sounds for diagnosing respiratory ailments | Scientific Reports

  https://www.nature.com/articles/s41598-023-50371-2

  This approach not only aims to enhance the understanding and application of AI in healthcare but also to fill a significant research gap in cough biomarker identification and the acoustical properties of cough for disease diagnosis. […] The application of the Mann-Whitney U test to our study data revealed statistically significant differences in the RP of cough sound signals between COVID-19-positive individuals and a COVID-19-negative control group, particularly in the 300-400 Hz and 1100-1650 Hz frequency bands. […] These results underscore the potential of RP in cough sound signals as a significant biomarker for COVID-19, especially within these specific frequency bands. […] Our study contributes novel insights into the field of respiratory disease diagnosis using cough sound signals, particularly for COVID-19, augmenting the existing body of literature that predominantly focuses on deep learning models like convolutional neural networks. […] This research represents an initial step towards a comprehensive understanding of cough sounds and their diagnostic potential.

• #1 Cough – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493221/

  A chronic cough is a more difficult diagnosis to elucidate and typically will require referral to a cough specialist or a pulmonologist for evaluation. Possible causes include upper airway cough syndrome, gastroesophageal reflux disease, non-asthmatic eosinophilic bronchitis, chronic bronchitis, postinfectious cough, intolerance to angiotensin-converting enzyme inhibitor medication, malignancy, interstitial lung diseases, obstructive sleep apnea, chronic sinusitis, and psychosomatic cough. […] Management of cough may require teamwork by different specialties. New onset of a chronic cough without obvious etiology should prompt a referral to a pulmonologist or cough specialist. If poor cardiac function is suspected, then a referral to a cardiologist is recommended for the evaluation of congestive heart failure. If a gastrointestinal aberration is suspected, such as gastroesophageal reflux disease, referral to a gastroenterologist is warranted.

• #1 Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia | The Medical Journal of Australia

  https://www.mja.com.au/journal/2024/220/1/cough-children-and-adults-diagnosis-assessment-and-management-cicada-summary

  In both adults and children, estimating duration of cough is critical in assessment. A chronic cough is defined as a daily cough for 4 weeks in children, and 8 weeks in adults. The initial assessment for chronic cough relies on history and examination to identify any red flags indicators that may signal an underlying disease or systemic exposure. Probability-based algorithms are an important clinical decision tool and are presented for both children and adults separately. Initial assessment should always include a chest xray and spirometry (age, 6 years). […] In children, specific cough refers to a cough that occurs with a condition known to be associated with or cause a chronic cough. Identification of the conditions associated with chronic cough forms the basis of specific treatment and investigation.

• #1 How to Diagnose and Treat a Cough

  https://www.verywellhealth.com/what-to-do-about-a-cough-770770

  Most uncomplicated coughs due to cold or flu can be treated at home. There are times, however, when a persistent or severe cough warrants a visit to your healthcare provider. Generally speaking, you should see a healthcare provider if: […] You have a cough that has lasts longer than a week. […] Your cough is extremely painful. […] You are coughing up blood. […] You have a persistent fever of 100.4 F (38 C) or higher. […] You are persistently coughing up green mucus (briefly producing green mucus is not a cause for concern). […] You have shortness of breath, wheezing, or chest tightness. […] You have a history of heart problems. […] Your cough is accompanied by night sweats. […] You think your child has croup. […] Go to the emergency room immediately if you are coughing up pink, frothy mucus or your child is choking or having trouble breathing or swallowing.

• #1 Clinical Practice Guidelines for Diagnosis and Management of Cough—Chinese Thoracic Society (CTS) Asthma Consortium – Lai – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/25427/html

  GERC is a special kind of gastroesophageal reflux disease that presents with chronic cough as the sole or predominant symptom. Studies have showed that GERC is a common cause of chronic cough. The prevalence of patients with GERC is lower in China than that in Western countries. The pathogenesis of GERC involves microaspiration, esophageal-bronchial reflux, esophageal motility dysfunction, autonomic nervous system dysfunction, or neurogenic airway inflammation. […] In most patients with chronic cough, an etiologic diagnosis can be determined and cough can resolve after treatment. However, in some patients with chronic cough an etiologic diagnosis cannot be confirmed after a comprehensive investigation and therapy aimed at known causes. Traditionally, this type of cough is called unexplained cough, chronic refractory cough, or idiopathic cough. The diagnosis of unexplained chronic cough should include the following: all known causes of chronic cough have been excluded through systematic evaluation and patients fail to respond to etiology-targeted treatment.

• #2 Cough in Adults – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/symptoms-of-pulmonary-disorders/cough-in-adults

  Cough is a protective reflex that prevents aspiration and expels particles and irritants from the airway. However, it can become uncontrolled or disabling and is one of the most common symptoms prompting physician visits. […] Likely causes of cough differ depending on whether the symptom is acute (present 8 weeks) or chronic. […] In acute cough, the most common causes are upper respiratory infection (URI), including acute bronchitis, postnasal drip, and pneumonia. […] In chronic cough, the most common causes are postnasal drip, gastroesophageal reflux, asthma, chronic bronchitis, COPD (chronic obstructive pulmonary disease), airway hyperresponsiveness after resolution of a viral or bacterial respiratory infection, and angiotensin-converting enzyme (ACE) inhibitors. […] Purely psychogenic cough is rare and is a diagnosis of exclusion. However, patients with chronic cough may develop a secondary reflex or psychogenic component to their cough.

• #2 Cough: Causes, Emergency Symptoms, Treatment, Prevention

  https://www.healthline.com/health/cough

  A cough isnt usually concerning unless it lingers for more than two weeks or you have additional symptoms such as difficulty breathing. […] Contact a doctor or healthcare professional if your cough doesnt improve within a few weeks. This could indicate a more serious condition. […] A cough that lasts for less than 3 weeks is an acute cough. If a cough lasts between 3 and 8 weeks, improving by the end of that period, its considered a subacute cough. A persistent cough that lasts more than 8 weeks is a chronic cough. […] Contact a doctor if you have a cough that hasnt cleared up or improved in 2 weeks. It may be a symptom of a more serious problem. […] If the doctor cant determine the cause of your cough, they may order additional tests. […] A chest X-ray helps them assess whether your lungs are clear.

• #2 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  Patients may present with a subacute cough, most commonly postinfection; however, in most patients, postinfectious cough is self-limited. […] Once the cough persists for longer than 8 weeks, further evaluation is indicated. […] Several validated tools of cough assessment are available, although these are used mostly for research purposes. […] Pursuing the cause and resolution of chronic cough requires ongoing commitment to the patient. The approach to an individual patient with chronic cough may vary from full initial diagnostic evaluation for common associated diseases, to empiric but targeted therapy for common conditions known to cause chronic cough, with limited or no diagnostic efforts. […] In practice, diagnostic and therapeutic processes are often applied simultaneously. It is best to involve the patient in choosing the best approach and to explain the expected duration and course of diagnostic and therapeutic trials.

• #2 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  A detailed history is essential, and should include: Time and clinical setting of onset, Exacerbating factors, Associated symptoms, Prior history suggestive of atopic disease, A complete medical, smoking, drug, and exposure history, Occupational and family history, What measures have already been tried, and to what effect. […] The history substantially influences the clinician’s impression as to which (if any) of the four most common etiologies (upper airway cough syndrome [UACS], asthma, gastroesophageal reflux disease [GERD], or nonasthmatic eosinophilic bronchitis [NAEB]) are most likely. […] A careful examination is, unfortunately, unlikely to inform the clinician regarding the commonest causes of chronic cough, but is essential for early detection of less common causes, such as bronchiectasis, interstitial lung disease, neoplastic disorders, or chronic infectious pulmonary diseases.

• #2 Patient education: Chronic cough in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/chronic-cough-in-adults-beyond-the-basics

  Coughing from time to time helps clear particles and secretions from the lungs and helps to prevent infection. However, sometimes a cough can become a chronic condition. A chronic cough is usually defined as a cough that lasts for eight weeks or longer. […] The most common causes of chronic cough are postnasal drip, asthma, and acid reflux from the stomach. These three causes account for up to 90 percent of all cases of chronic cough. […] To investigate the cause of a chronic cough, your healthcare provider will ask about your symptoms and perform a physical examination. […] If asthma is suspected but cannot be confirmed, the clinician may perform lung function tests that measure the pattern of air flow into and out of the lungs. […] Treatment of chronic cough aims to eliminate the underlying cause. Most of the time, each type of treatment is tried separately, one after another, instead of all at the same time.

• #2 Evaluation of chronic cough – Diagnosis Approach | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/69/diagnosis-approach

  Although no specific history or physical exam findings are reliably associated with specific etiology of chronic cough, they may direct further testing or therapeutic trials. […] The symptoms and findings associated with the common causes (asthma, UACS, GERD, or NAEB) may direct further diagnostic evaluation toward confirming that cause. […] A chest x-ray should be obtained early in the evaluation of chronic cough. […] Although it is not diagnostic of the most common causes, findings may quickly divert the evaluation to causes of greater gravity, such as structural lung diseases. […] Following chest x-ray, the choice of either diagnostic testing or therapeutic trials depends on the clinician’s assessed probability of a specific etiology and the patient’s preferred approach. […] Unless the history, physical examination, and chest x-ray indicate otherwise, efforts should be concentrated on one or more of the four most common causes (asthma, UACS, GERD, NAEB).

• #2 The spectrum, clinical features and diagnosis of chronic cough due to rare causes – Lai – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/51121/html

  This study showed that many rare causes of chronic cough were misdiagnosed as chronic bronchitis or chronic pharyngitis. […] Therefore, the diagnosis of chronic bronchitis, chronic pharyngitis or UC should be made very carefully when common causes of chronic cough are ruled out. […] Our study showed that chest HRCT resulted in high positive rates in the diagnosis of rare causes. […] Therefore, we propose that HRCT and bronchoscopy should be considered if no abnormalities are observed in routine examinations and if patients do not respond to empirical treatment. […] In conclusion, rare causes of chronic cough accounted for 13.1% of all causes of chronic cough in this cohort. […] Special examinations such as HRCT and bronchoscopy play an important role in diagnosing rare causes and should be considered based on the patients condition after excluding common causes of chronic cough.

• #2 Cough – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493221/

  A chronic cough is a more difficult diagnosis to elucidate and typically will require referral to a cough specialist or a pulmonologist for evaluation. Possible causes include upper airway cough syndrome, gastroesophageal reflux disease, non-asthmatic eosinophilic bronchitis, chronic bronchitis, postinfectious cough, intolerance to angiotensin-converting enzyme inhibitor medication, malignancy, interstitial lung diseases, obstructive sleep apnea, chronic sinusitis, and psychosomatic cough. […] Management of cough may require teamwork by different specialties. New onset of a chronic cough without obvious etiology should prompt a referral to a pulmonologist or cough specialist. If poor cardiac function is suspected, then a referral to a cardiologist is recommended for the evaluation of congestive heart failure. If a gastrointestinal aberration is suspected, such as gastroesophageal reflux disease, referral to a gastroenterologist is warranted.

• #2

  https://link.springer.com/article/10.1007/s41030-019-0089-7

  There is a 92% probability, based on prospective trials, that in patients who have been treated unsuccessfully for UACS, asthma, and NAEB, not on an ACE and with a normal CXR, that their chronic cough is due to GERD. […] Spirometry is the gold standard to diagnose asthma and COPD, but false positives can exist with some conditions that can cause confusion. […] The diagnosis of GERD can be critically performed by the use of dual-channel 24-h pH probe monitoring, but this is not a first-line investigation and should be considered in those refractory to therapy. […] Chronic cough is common, disabling, and may not have a readily obvious cause. The use of an algorithmic approach such as the ACCP guidelines can give you a roadmap to making the diagnosis. It is tempting to just try ICS, but in the absence of evidence of eosinophilic inflammation, this should be avoided. Go to the effort of making a firm diagnosis, most often one of the big three of UACS, GERD, or asthma, especially in those without any red flags and your success of treatment will be much higher.

• #2 Diagnosing Chronic Cough | NYU Langone Health

  https://nyulangone.org/conditions/chronic-cough-in-children/diagnosis

  Through physical exams and other tests, our pulmonologists can diagnose the cause of your child’s chronic cough. […] Our specialists can diagnose the precise cause of your child’s chronic cough. Our pulmonologists, or lung specialists, begin with a comprehensive physical exam to assess your child’s symptoms, followed by additional tests to check for bacterial infection and to rule out other possible causes. […] If needed, our pulmonologists make referrals to other specialists, such as gastroenterologists or infectious disease specialists, who can confirm and treat less common causes of chronic cough in children. […] In a sputum culture, a doctor takes a sample of your child’s mucus, if enough can be produced from coughing, to look for the presence of a bacterial infection. […] Lung function tests play a major role in identifying the cause of a chronic cough and can be performed in children as young as age 5. […] This test may be used when the cause of a chronic cough cannot be determined with a physical exam and sputum culture, or if the cough remains after treatment. […] After our doctors establish the correct diagnosis, the next step is to select the appropriate treatment for your child.

• #2 Chronic Cough: Practice Essentials, Mechanism of Cough, Causes of Chronic Cough

  https://emedicine.medscape.com/article/1048560-overview

  The hallmarks of asthma are variable airflow obstruction and airway hyperresponsiveness, which manifest as shortness of breath, wheezing, dyspnea, and cough. Cough occurs in all asthmatics, and in a subset of patients with cough-variant asthma (CVA), it is the only presenting symptom. The treatment of asthma, regardless of whether it is of the cough variant or not, includes beta-2 agonists and corticosteroids. […] The criterion standard for diagnosis of GERD is dual-channel 24-hour pH probe monitoring. Alternatively, flexible nasopharyngoscopy can reveal glottic changes associated with reflux. […] NAEB has been implicated as an etiology of chronic cough in 13-33% of patients. It is characterized by eosinophilic infiltration of the bronchial tree as well as the absence of variable airflow obstruction and airway hyperresponsiveness. This disease is highly responsive to inhaled corticosteroids.

• #2 Laboratory Testing for Pertussis | Whooping Cough | CDC

  https://www.cdc.gov/pertussis/php/laboratories/index.html

  Clinical laboratories can provide diagnostic testing for pertussis. […] Culture is considered the gold standard. […] Other tests that can be performed include polymerase chain reaction (PCR) and serology. […] The advantages and disadvantages for specimen collection for each test method. Method Advantages Disadvantages Culture Gold standard for pertussis diagnosis. The only 100% specific method for identification. Better specificity than PCR. Takes up to 7 days to obtain results. PCR Most rapid test available. Excellent sensitivity. PCR assays that include multiple target sequences allow for speciation among Bordetella species. Tests can vary in specificity. High sensitivity increases risk of false-positivity but best practices can reduce risk of inaccurate results. Serology Can be performed much later in the course of disease than culture and PCR. Some commercially available tests have unproven or unknown clinical accuracy.

• #2 Idiopathic chronic cough: a real disease or a failure of diagnosis? | Cough | Full Text

  https://coughjournal.biomedcentral.com/articles/10.1186/1745-9974-1-9

  Despite extensive diagnostic evaluation and numerous treatment trials, a number of patients remain troubled by a chronic and uncontrollable cough. […] Eosinophilic bronchitis, atopic cough and non-acid reflux have been recently added to the diagnostic spectrum for chronic cough. […] In some cases, failure to consider these conditions may explain treatment failure. […] However, a subset of patients with persisting symptoms may be regarded as having an idiopathic cough. […] This article seeks to examine the evidence for idiopathic cough as either a distinct diagnosis or simply the result of incomplete evaluation and inadequate courses of therapy. […] Although the systematic evaluation of both extrapulmonary and pulmonary causes for cough is widely held to be effective, doubt has been cast on the perception that the diagnostic triad of CVA, PNDS and GORD accounts for the almost all causes of chronic cough.

• #2 Clinical Practice Guidelines for Diagnosis and Management of Cough—Chinese Thoracic Society (CTS) Asthma Consortium – Lai – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/25427/html

  Chronic cough hypersensitivity syndrome is now used to describe patients with this type of chronic cough. Based on the pathophysiological characteristics of CHS, the treatment should be aimed to reduce the sensitivity of cough. However, therapeutic options for CHS including medicinal and non-medicinal treatment are limited. Clinical studies show that neuromodulators, for example gabapentin, are effective in the treatment of CHS. Other medicines including amitriptyline, baclofen, carbamazepine, and pregabalin may be useful in CHS. Other potential treatments including speech therapy, and cough suppression physical therapy. […] Successful treatment of chronic cough depends on etiologic diagnosis. Etiologic diagnosis may require specific equipment and techniques, which are not available in primary care hospitals, and are difficult for patients of low socioeconomic status to afford. Consequently, empirical treatment is an alternative in cases where conditions are limited. Empirical treatment should follow the principles targeting the common causes of chronic cough.

• #2

  https://link.springer.com/article/10.1007/s41030-019-0089-7

  Chronic cough is common and impactful, frustrating both patients and clinicians. An empirical trial of therapy is often done with inhaled corticosteroids, but this practice should be replaced with attempting to make an accurate diagnosis. The three most common causes are upper airway cough syndrome, asthma, and gastroesophageal reflux disease (GERD), but there are often multiple causes involved. Minimal investigations after history, physical exam, travel history, and drug history include a chest radiograph and spirometry. Empirical trial of therapy with inhaled corticosteroids is reasonable if there is evidence of eosinophilic inflammation. Empiric therapy for GERD may also be reasonable in those with symptoms. Red flags should especially be considered an urgency to make the correct diagnosis.

• #2 Cough: Causes, Diagnosis, Treatment & Conditions

  https://my.clevelandclinic.org/health/symptoms/17755-cough

  A cough is a reflex reaction designed to keep your airways clear. […] Your healthcare provider can help you figure out whats going on. […] A cough is a natural reflex that is your bodys way of removing irritants from your upper (throat) and lower (lungs) airways. A cough helps your body heal and protect itself. […] Anyone can get a cough. A cough is the most common symptom reported in healthcare providers’ offices. […] In general, call your healthcare provider if you have a cough that will not go away and these symptoms: Wheezing (noise when you breathe out). […] To diagnose whats behind your cough, your healthcare provider will take a medical history, give you a physical exam, and may order some tests. […] Cough is a symptom of COVID-19. It can also be part of a post-COVID syndrome (or long COVID). […] If you also have other symptoms like trouble breathing, fever, trouble eating or sleeping, or youre coughing up bloody or colored sputum, call your healthcare provider for advice.

• #3 What Is a Cough? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/cough/guide/

  In the United States, cough is the most common reason people seek medical attention and is the second most common reason for a general medical examination, adding up to more than 26 million office visits annually. […] Chronic cough is cited as the reason for up to 38 percent of pulmonary outpatient visits.

• #3 Chronic Cough: Practice Essentials, Mechanism of Cough, Causes of Chronic Cough

  https://emedicine.medscape.com/article/1048560-overview

  Only when management of the most common causes has failed to yield a resolution of cough should a more extensive workup begin. This can include induced sputum testing for acid-fast bacillus, high-resolution CT scanning of the chest, and bronchoscopy. Often, these tests should be performed by a cough specialist. If further testing does not reveal the cause, then the patient most likely has chronic cough hypersensitivity syndrome. Owing to inflammation and hyperresponsiveness of the airway from some inciting cause, tissue remodeling has occurred, leading to an enhanced cough reflex that maintains the cough even though the inciting cause has resolved. […] In the immunocompetent nonsmoking patient who does not take angiotensin-converting enzyme (ACE) inhibitors, the most common causes of chronic cough are upper airway cough syndrome (UACS), asthma, and gastroesophageal reflux disease (GERD). Together, these causes account for more than 90% of all cases of chronic cough. Frequently more than one of these etiologies is present, and cough may be the only presentation. Nonasthmatic eosinophilic bronchitis (NAEB) should also be considered early in the diagnostic evaluation because it is easily diagnosed and treated. Only after these most common causes of chronic cough are ruled out should more extensive testing be performed, usually after referral to a cough specialist. An empiric and integrative approach that uses sequential and additive therapy is needed to systematically evaluate and effectively treat patients with chronic cough.

• #4 Cough – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493221/

  Cough is one of the most common medical complaints accounting for as many as 30 million clinical visits per year. Up to 40% of these complaints result in a referral to a pulmonologist. A cough is an innate primitive reflex and acts as part of the body’s immune system to protect against foreign materials. Coughing is associated with a wide assortment of clinical associations and etiologies. Furthermore, there are no objective tools to measure or clinically quantify a cough. This activity reviews the workup of an unexplained cough and highlights the role of the interprofessional team in evaluating and improving care for patients with cough. […] A cough is one of the most common medical complaints accounting for as many as 30 million clinical visits per year. Up to 40% of these complaints result in referral to a pulmonologist. A cough is an innate primitive reflex and acts as part of the body’s immune system to protect against foreign materials. Coughing is associated with a wide assortment of clinical associations and etiologies. Furthermore, there are no objective tools to measure or clinically quantify a cough. As such, the evaluation of a cough is initially a subjective and highly variable assessment. Given the vagueness of this symptom’s nature, along with the risk of an insidious underlying etiology, heavy impact on quality of life, and a lack of objective tools, coughing should be evaluated and treated as an important issue until a benign source is isolated.

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