Postinfectious Cough: Diagnosis
Children under 5 years of age have 3.8 to 5 infections per person per year. Those children in daycare are especially at risk. Back-to-back infections, which are particularly common in winter months, can frequently result in a chronic cough, Similarly, coinfection with more than one of these organisms can occur, and this can increase the period of paroxysmal coughing. Prolonged cough after Chlamydophila and Mycoplasma infections may also be quite common. A duration of cough of > 21 days in young children following pneumonia with these organisms has been found in 57% and 28% of patients, respectively.
The diagnosis of postinfectious cough is clinical and one of exclusion. A careful medical history, including knowledge of the medical history of contacts, and sometimes the physical examination may provide clues to the diagnosis. As the cough is usually self-limited, it will resolve in time. When M pneumoniae infection is suspected, as in school-age children or young adults, particularly in military personnel, in late summer or fall, acute and convalescent-specific serologic studies may help to confirm the diagnosis. generic yaz
3. In children and adult patients with cough following an acute respiratory tract infection, if cough has persisted for > 8 weeks, consider diagnoses other than postinfectious cough.
Quality of evidence, low; net benefit, intermediate; strength of recommendation, C. The postinfectious cough is self-limited and will usually resolve in time. Therapy with antibiotics has no role in the treatment of postinfectious cough, as there is no evidence that bacterial infection plays a role. Based on the speculation that the postinfectious cough is due to inflammation, some authors in uncontrolled studies have successfully treated the cough with a brief course of corticosteroids starting with 30 to 40 mg of prednisone (or equivalent) in the morning, tapering to zero over 2 to 3 weeks.
Category: Respiratory Symptoms
Tags: Bordetella pertussis, pertussis infection, postinfectious cough, postviral cough