Cough

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Cough
ICD-10	R05
ICD-9	786.2

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] M.Umer Tariq [3]

Synonyms and keywords: Tussis

Complete List of Differential Diagnoses Sorted by Nonproductive vs Productive Nature of Cough

Nonproductive Cough

• Smoker's cough
• Aspiration
• Congestive heart failure
• Postnasal drip

  • Most common cause of chronic cough in nonsmokers

• GERD

  • Second most common cause of chronic cough in nonsmokers

• Asthma/reactive airway disease
• ACE inhibitor use
• Pneumonia

  • Typical pneumonia is characterized by acute or subacute onset of fever, dyspnea, fatigue, pleuritic chest pain, and cough
  • Atypical pneumoniais characterized by more gradual onset, dry cough,headache, fatigue, and minimal lung signs

• Acute bronchitis

  • Most commonly caused by viruses
  • Postviral bronchitis may last beyond 6 weeks

• Aspirated foreign body
• Lung cancer
• COPD
• Sarcoidosis
• Cryptogenic organizing pneumonia
• Filarial disease

Productive Cough

• Postnasal drip
• Tuberculosis
• COPD
• Lung cancer
• Smoker's cough
• Asthma with secondary infection
• Pneumonia
• Bronchitis

Complete Differential Diagnosis of Cough Sorted by Frequency of Causes

In alphabetical order.

Complete Differential Diagnosis of the Causes of Cough

(By organ system)

Cardiovascular	Aortic arch anomalies, Atrial myxoma, Beriberi Heart Disease, Congestive Heart Failure, Hypotension, Mitral stenosis, Right Ventricular Outflow Tract Obstruction, Superior Vena Cava Syndrome, Thoracic Aortic Aneurysms,
Chemical / poisoning	Abrin, Cadmium poisoning, Polymer fume fever,
Dermatologic	No underlying causes
Drug Side Effect	Abacavir , Abatacept , ABVD, ACE inhibitor, Acetylmorphone, Acyclovir , Adalimumab , Adefovir , Albuterol , Alefacept , Alfuzosin , Aliskiren , Amiodarone , Amlodipine and Benazepril , Amphotericin B , Anagrelide , Anastrozole , Atazanavir , Benazepril, Bepridil , Bevacizumab , Bitolterol , Bortezomib , Brimonidine , Budesonide, Busulfan , Captopril, Carvedilol , Cetuximab , Cevimeline, Chlorambucil , Cladribine , Clobutinol, Clofarabine , Clofedanol, Co-trimoxazole , Cromolyn Sodium , Cytarabine , Dacarbazine , Dactinomycin , Darbepoetin Alfa , Diborane, Docetaxel , Domiodol, Dornase alfa, DTPA, Efalizumab , Efavirenz , Emtricitabine , Enalapril , Enfuvirtide, Epinastine , Eplerenone , Epoetin Alfa , Eprosartan , Erlotinib , Estradiol Topical , Etanercept , Fexofenadine , Floxuridine , Fludarabine Phosphate , Fluorouracil , Fluticasone and Salmeterol , Fluvastatin , Fosamprenavir , Fosinopril , Gabapentin , Gefitinib , Gemcitabine Hydrochloride , Glyburide and Metformin , Granisetron , Histrelin , Ibandronate , Ifosfamide , Iloprost, Imipramine, Insulin Human (rDNA Origin) , Interferon beta-1a Intramuscular , Isoproterenol , Ketorolac, Lamivudine , Lamotrigine , Letrozole , Levalbuterol , Lisinopril , Lomustine , Mechlorethamine , Melphalan , Mercaptopurine , Mesalamine , Metaproterenol , Methotrexate , Metoprolol, Mitomycin , Moexipril , Moxifloxacin , Mycophenolic acid, Natalizumab , Nateglinide , Nedocromil , Nicotine nasal spray , Nilutamide , Nitrofurantoin , Omeprazole , Oxaliplatin , Oxcarbazepine , Paclitaxel, Pamidronate , Peginterferon alfa-2a , Pemetrexed , Penbutolol , Pentamidine, Perindopril, Pegaspargase , Pimecrolimus topical , Pirbuterol acetate , Plicamycin , Primaquine , Procarbazine , Prograf, Quinapril, Ramelteon , Ramipril, Ribavirin , Risedronate , Risperidone , Rosiglitazone , Rosuvastatin , Salmeterol , Saquinavir , Sevelamer , Sirolimus , Sodium stibogluconate, Spironolactone , Sulindac , Tacrolimus, Tamsulosin , Thioguanine , Thiotepa , Tipranavir , Tocainide , Topotecan Hydrochloride , Trandolapril, Trimetrexate Glucuronate , Vinorelbine Tartrate , Vorinostat , Zanamivir , Ziprasidone ,
Ear Nose Throat	Acute viral nasopharyngitis (common cold), Adenoid hypertrophy, Allergic rhinitis, Atopic rhinitis, Croup, Goiter, Laryngitis, Laryngopharyngeal Reflux Disease, Laryngotracheal cleft, Pharyngitis, Post-nasal drip, Strep throat, Subglottic hemangioma, Subglottic stenosis, Tonsillolith,
Endocrine	Goiter,
Environmental	Caplan's Syndrome, Chronic beryllium disease (CBD), Hay fever, Low humidity, Occupational exposure of irritants Passive smoking, Sick building syndrome, Silicosis, Smoking,
Gastroenterologic	Achalasia, Esophageal atresia, Esophageal cancer, Esophageal dysmotility, Gastroesophageal reflux disease, Mallory-Weiss syndrome,
Genetic	Cystic fibrosis, Juvenile Myelomonocytic Leukemia (JMML),
Hematologic	No underlying causes
Iatrogenic	Chest tube, Thoracentesis, Transfusion-associated graft versus host disease,
Infectious Disease	Adenoviridae, Aphthovirus, Ascaris infection, Aspergillosis, Blastomycosis, Bordetella pertussis, Byssinosis, Chickenpox, Chlamydophila pneumoniae, Cladosporium, CMV Pneumonitis, Coccidioidomycosis, Community-acquired pneumonia, Cryptococcosis, Fasciolosis, Filariasis, Gnathostomiasis, Histoplasmosis, Human ehrlichiosis, Infectious mononucleosis, Influenza, Lady Windermere syndrome, Lassa fever, Legionellosis, Measles, Melioidosis, Miliary tuberculosis, Mucor stolonifer, Mycoplasma pneumoniae, Nocardiosis, Paprika splitter's lung, Paracoccidioidomycosis, Papillomatosis, Paragonimus Infection, Pneumocystis jirovecii pneumonia, Psittacosis, Q Fever, Rhinovirus, Saccharopolyspora rectivirgula, Schistosomiasis, Sporotrichosis, Strep throat, Thermoactinomyces sacchari, Thermoactinomyces vulgaris, Trichinosis, Tuberculosis, Tularemia, Typhoid fever, Upper respiratory tract infection, Yersinia Pestis Infection,
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	Beriberi Heart Disease, Cholesterol pneumonia,
Obstetric/Gynecologic	Bronchogenic cyst, Pulmonary sequestration, Esophageal atresia, Peripartum cardiomyopathy,
Oncologic	Cervical mass, Esophageal cancer, Kaposi's sarcoma, Laryngeal cancer, Lymphangitis carcinomatous, Mediastinal tumor, Mesothelioma, Papillomatosis, Thymoma,
Opthalmologic	No underlying causes
Overdose / Toxicity	Ganciclovir , Nickel carbonyl, Valganciclovir , Salicylate sensitivity,
Psychiatric	Psychogenic cough,
Pulmonary	Acute bronchitis, Acute Chest Syndrome, Allergic bronchopulmonary aspergillosis, Asthma, Atelectasis, Atypical pneumonia, Aspergillosis, Blastomycosis, Bronchial stenosis, Bronchial web, Bronchiectasis, Bronchiolitis, Bronchitis, Bronchogenic cyst, Chronic Obstructive Pulmonary Disease, Ciliary dyskinesia, Cystic fibrosis, Goodpasture's syndrome, Hamman-Rich syndrome, Idiopathic Pulmonary Fibrosis, Interstitial pneumonia, Lady Windermere syndrome, Lung abscess, Pleurisy, Pleuropulmonary blastoma, Pulmonary alveolar proteinosis, Pulmonary Embolism, Pulmonary hypertension, Severe acute respiratory syndrome, Tracheal stenosis, Tracheitis, Tracheoesophageal fistula, Tracheomalacia,
Renal / Electrolyte	Congenital nephrotic syndrome, Rapidly progressive glomerulonephritis,
Rheum / Immune / Allergy	Sarcoidosis,
Sexual	No underlying causes
Trauma	Post cerebrovascular accident,
Urologic	No underlying causes
Miscellaneous	Alcoholism, Aspirated foreign bodies, Cerumenosis, Choking, Chronic Fatigue Syndrome, Ear foreign body, Hair in the ear canal,

Complications

The complications of coughing can be classified as either acute or chronic. Acute complications include cough syncope (fainting spells due to decreased blood flow to the brain when coughs are prolonged and forceful), insomnia, cough-induced vomiting, rupture of blebs causing spontaneous pneumothorax, subconjunctival hemorrhage or "red eye", coughing defecation and in women with a prolapsed uterus, cough urination. Chronic complications are common and include abdominal or pelvic hernias, fatigue fractures of lower ribs and costochondritis.

Treatment

Coughs can be treated with cough medicines. Dry coughs are treated with cough suppressants (antitussives) that suppress the body's urge to cough, while productive coughs (coughs that produce phlegm) are treated with expectorants that loosen mucus from the respiratory tract. Centrally acting cough suppressants, such as codeine and dextromethorphan reduce the urge to cough by inhibiting the response of the sensory endings by depolarization of the vagus nerve. A recent study indicates that, because of the presence of theobromine in chocolate, 50 grams of dark chocolate may be an effective treatment for a persistent cough.

Gargling with salt and warm water can also be helpful by reducing phlegm.

During injections

Coughing during an injection can lessen the pain of the needle stick caused by a sudden, temporary rise in pressure in the chest and spinal canal, inhibiting the pain-conducting structures of the spinal cord.

See also

• Whooping cough
• Kennel cough
• Cough medicine

Additional Resource

• McCool F (2006). "Global physiology and pathophysiology of cough: ACCP evidence-based clinical practice guidelines". Chest. 129 (1 Suppl): 48S–53S. PMID 16428691.Full text

External links

• FamilyDoctor.org – Chronic cough: causes and cures
• Coughing:Quick tips to help stop a coughing fit.

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