CHRONIC COUGH


Etiology:

I. Lower respiratory tract

  1. Asthma or other COPD
  2. Neoplasm
  3. Eosinophilic bronchitis (sputum eosinophilia w/o evidence of asthma on spirometry or provocative testing; us. responds well to inhaled steroids)
  4. Other lung disease

II. Upper respiratory tract

  1. Postnasal drip
  2. Irritants (e.g. cigarette smoke)
  3. Pertussis is a common cause: out of 153 adults presenting in San Francisco with cough x > 2wks, serologic testing indicated recent pertussis infection in 12.4% (JAMA 275:1672, 1996-JW)

III. GERD (up to 20% of pts with chronic cough--Lancet 353:944, 1999--AFP)

IV. ACE-Inhibitor use

V. Heart Failure

VI. Aspiration of oropharyngeal contents