Etiologies of chronic cough in adult patients: Is it hard to be diagnosed?

Abstract

Background: Chronic cough is often the key
symptom not only of chronic pulmonary diseases
but for other important extrapulmonary
pathologies, in particular upper airway and
gastrointestinal diseases.
Objective: This study was designed to
determine the etiology of chronic cough and the
usefulness of the available diagnostic tests in
reaching its causes.
Methods: One hundred patients presenting with
chronic cough at Baghdad Teaching Hospital
Outpatient Clinic were enrolled in this study. The
patients underwent a full clinical interview,
physical examination with indicated diagnostic
test(s) (such as chest x ray, bronchoscope, PFT,
GIT study, sinus X ray or CT).
Results: An etiology of chronic cough was
determined in 93% of the patients. Post nasal drip
is the leading cause of chronic cough reported in
31% of the patient, while asthma gastroesophageal
reflux disease, and chronic bronchitis
seen in (26, 20, and 6 % respectively).
The diagnosis of chronic cough can be reached by
comprehensive history, proper physical
examination, and chest X ray findings in 66 %
patients, further more sophisticated and invasive
tests like: PFT, upper GIT study , expectorated
sputum examination (AFB, Gram staining,
cytology), fibrooptic bronchoscope, and full ENT
evaluation including sinuses X ray or sinuses CT
scanning, are need in the rest.
Conclusion: The etiology of chronic cough can
often be diagnosed safely with a simple initial
evaluation (history, physical examination and
chest X-ray). Postnasal drip, asthma and
gastroesophageal reflux disease account for the
etiology in more than three quarter of the patients.