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Lung diseases

Constant Cough

06/11/2010

Question:

my 15 yr old son had pneumonia in dec 2009 he has from that date had a constant cough dry non prod. he uses albuterol inhaler which does not help . it is so bad at times he can not speak in full sentences.he is not wheezing and in fact his lungs sound clear.(i am an RT) cough meds do not seem to help either.what do you suggest he has allergies and takes zertek daily.

Answer:

The list of items that can cause a chronic cough is quite extensive. Asthma is one of the more common issues; asthma related coughing can occur in the absence of wheezing and, if the airways have become quite swollen, may not respond well to a bronchodilator alone. Other common issues include post-nasal drip (from allergy or sinusitis) or gastroesophageal reflux related cough. Much less commonly, issues like retained foreign body or tic disorder may cause a persistent cough. Habit or vocal cord dysfunction related cough can be seen in this age group as well. There are other issues to consider as well.

Given that this started with "pneumonia," a follow-up CXR to make sure the initial infiltrate cleared seems in order. Further testing, or trials of medication, would be based on additional information gleaned from the history and physical exam. You should begin with your son's primary care physician and, if initial evaluation/treatment is unsuccessful, you may need further specialist input.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University