Cause Of Acute Cough Research Articles

Experience in the use of phytotherapy in the treatment of bronchitis in children

Introduction. Cough is one of the most common symptoms faced by a pediatrician in clinical practice. The most common cause of acute cough in children is a viral infection. A growing amount of scientific data indicates that phytotherapy is an effective and safe form of auxiliary treatment of acute and chronic inflammatory diseases of the respiratory tract, accompanied by cough and sputum formation (tracheitis, tracheobronchitis, bronchitis).Aim. To evaluate the effectiveness of the use of herbal medicinal product (extract combination of thyme herb and Hedera helix leaves) in acute bronchitis, including in children with bronchitis of atypical etiology.Materials and methods. A comparative prospective follow-up of 60 outpatient patients aged 3–12 years with a diagnosis of Acute bronchitis was carried out. The patients were divided into groups: group 1 (n = 28) – receiving the phytopreparation, of which 8 children with mycoplasma bronchitis – a combination of herbal medicinal product + clarithromycin; group 2 (n = 32) – receiving ambroxol, of which 10 patients with mycoplasma bronchitis – a combination of ambroxol + clarithromycin. Patients were included in the study for 2–3 days of the disease, control points of examinations – 6–7 days and 10–12 days. The time period of the study is 2019–2021.Results. Against the background of taking the drug herbal medicinal product, there was a faster decrease in cough episodes (from 85 to 10% of patients), the transfer of dry cough to wet, as well as normalization of daily activities (95%), compared with ambroxol. The maximum effect was achieved by the 10th day of observation. In atypical bronchitis, results were obtained confirming the effectiveness and safety of using the drug herbal medicinal product with an antibiotic.Conclusions. The results obtained indicate the expediency of using the drug herbal medicinal product in acute bronchitis, including in combination with an antibiotic for bronchitis of atypical etiology.

Acute and chronic cough - differential diagnosis and treatment

Cough is a frequent reason for consultation in the general practitioner's office. Most of the time, the symptom is harmless and self-limiting, as in the case of a banal cold cough, for example - however, serious diseases such as malignancies can also be the cause. Evaluation is therefore not always easy. This article presents a targeted and appropriate approach and discusses which treatments are recommended and effective.Acute and chronic cough are differentiated according to the duration of symptoms (up to 8 weeks/longer than 8weeks). The most common cause of acute cough is a self-limiting viral infection of the upper respiratory tract; the most important differential diagnosis is community-acquired pneumonia. If there are no defined warning signs (red flags), the history and clinical examination are sufficient to establish the diagnosis in the case of an acute cough; medication is not necessary. In the case of a chronic cough, a chest X-ray is usually ordered and then further investigations are carried out in accordance with the most probable suspected diagnosis; probationary therapies are an important part of the workup. Coughs that are refractory to treatment or unexplained require individualised treatment (pharmacological, including off-label, non-pharmacological) and regular re-evaluation.

8 powodów, dla których warto stosować lewodropropizynę

The most common cause of acute cough are upper respiratory tract infections, but chronic one can be a symptom of many other lung diseases such as bronchial asthma, chronic obstructive pulmonary disease, lung cancer, as well as extrapulmonary pathologies. Dry cough can be a bothersome symptom that should be limited to allow daily functioning. It changes not only the quality of life and the quality of sleep of a sick person, it is also associated with significant economic costs. In therapy, we use only a few active substances, one of them is levodropropizine. The following paper discusses its clinical value.

Progress in the pathogenesis of post-infectious persistent cough

Respiratory viral infection is a common cause of acute cough. After the cause has been cleared and the symptoms such as fever, nasal congestion and runny nose have been relieved, some patients still have persistent cough. These phenomena indicate that respiratory viruses may mediate cough hypersensitivity and lead to the occurrence of sub-acute or chronic cough. Cough response to viral infection is a protective strategy to prevent the spread of the viruses from the upper respiratory tract to other sites, but excessive coughing becomes a disease. In this review, we introduced the research progress in the pathophysiological mechanism of post-viral persistent cough or chronic cough.

Acute and chronic cough-What is new?

Häufigste Ursache des akuten (bis zu 3 Wochen Dauer) oder subakuten (3–8 Wochen) Hustens ist ein viraler Infekt, der bei ansonsten gesunden Personen meist spontan abklingt. Einige pflanzliche Kombinationspräparate, Ambroxol und das Antitussivum Dextromethorphan erleichtern den Husten und verkürzen dessen Dauer. Antibiotika haben keinen Einfluss auf die Symptome und sollten wegen der Resistenzentwicklung nicht gegeben werden. Kann die Ursache eines ≥8 Wochen anhaltenden Symptoms Husten nach entsprechender Diagnostik keiner etablierten Krankheit zugeordnet werden, handelt es sich um eine eigenständige Erkrankung, den chronischen idiopathischen (unerklärten) Husten (CIH). Bei den Betroffenen ist die Sensitivität des Hustenreflexes erhöht, der schon durch schwache, unterschwellige Einflüsse wie langes Sprechen, Temperaturänderung, Gerüche usw. ausgelöst wird. Bei Nichtansprechen auf die leitliniengerechte Therapie wird vom chronisch refraktären Husten gesprochen.

The causes of acute cough: a tertiary-care hospital study in Japan

Objectives Cough is the most frequent presenting complaint in general practice and has an adverse effect on an individual’s well-being. Understanding the causes of cough is critical for appropriate patient management. According to its duration, cough is classified as acute, subacute, and chronic. While acute respiratory infection is considered to be the major cause of acute cough, there is little evidence. Methods We retrospectively assessed the prevalence of acute cough in all patients presenting with cough to the respiratory clinic of Japanese Red Cross Wakayama Medical Center from May 2018 to April 2019. We subsequently assessed the causes of acute cough, after stratifying patients with acute cough into two subgroups based on the chest X-ray findings. Results Among 685 patients (329 males; mean age, 61.8 ± 18.6 years) who presented with cough as a chief complaint, 274 (125 males; mean age, 57.6 ± 20.9 years) reported to have acute cough; chest X-ray abnormalities were detected in 113 of these patients. The most frequent cause of acute cough among 113 patients with chest X-ray abnormalities was pneumonia (55.8%), followed by lung cancer (9.7%) and pneumonia exacerbating asthma (7.1%). Among the 161 patients with acute cough without chest X-ray abnormalities, the most frequent cause was upper respiratory tract infection (57.1%), followed by asthma (23.6%) and cough variant asthma (6.2%). Conclusions Cough is the most frequent presenting complaint in general practice. Infections are the most frequent causes of acute cough regardless of the chest X-ray findings.

A COUGH IN A PATIENT WITH CHOLANGITIS IN THE COURSE OF CAROLI’S DISEASE. CASE REPORT

Cough may be a manifestation of pulmonary and extra-pulmonary diseases. However, rarely liver disease is suspected as a cause of acute cough. A case of a 34-year-old patient with diagnosed Caroli's disease has been described, in which cough with fever was the main manifestation of cholangitis in the course of complications of the underlying disease. Caroli's disease is a congenital pathology of intrahepatic bile ducts, causing their cysts to widen. It usually has an asymptomatic course, however it promotes infectious complications such as liver abscesses and recurrent cholangitis. The patient was admitted to the ward because of high fever and cough, without any symptoms from the digestive system. On the basis of laboratory, microbiological and visual examinations, various causes of cough were excluded and a diagnosis of cholangitis was made. After appropriate antibiotic therapy, a rapid improvement in the clinical condition and resolution of symptoms was achieved.

Age-related aspects of differential diagnosis of acute cough in children and adults

Cough is one of the most common causes of seeking the primary medical care, especially during the autumn and the spring. This article is a review of literature aimed at differential diagnosis of possible causes of acute cough in children and adults. Given a vast majority of diseases associated with cough, differential diagnosis have to consider several issues. The key issue is cough duration and possible anatomical location of the pathological changes. An algorithm of differential diagnosis of acute cough in children and adults and description of most common diseases associated with acute cough are given in the review. Further diagnostic work-up should be driven by the duration of cough as soon as the acute cough could be first manifestation of a chronic disease.

THE CAUSES OF ACUTE COUGH: A SINGLE-CENTER STUDY IN JAPAN

Cough is the most frequent presenting complaint in clinics, and is classified into the following three groups: acute, subacute and chronic. The major causes of acute cough are infectious diseases, however, few observations on acute cough have been reported. We retrospectively assessed the causes of acute cough among patients who had visited the respiratory clinic of our hospital because of acute cough from September 2014 to August 2015. Of 374 patients (195 females, mean age 60.3 years) who visited the clinic complaining of cough, 129 patients (63 females, mean age 61.5 years) suffered from acute cough. All acute cases were stratified into two groups based on the presence (n=43) or absence (n=86) of abnormal findings on the chest X-ray. The main causes of acute cough with abnormal findings were pneumonia (46.5%), interstitial pneumonia (18.6%) and lung cancer (16.3%). The main causes of acute cough without abnormal findings were respiratory tract infection (39.5%), post infectious cough (18.6%) and bronchial asthma (17.4%). Acute cough was the primary complaint in 29.5% and 19.6% of all patients diagnosed with bronchial asthma and cough variant asthma, respectively. Non-infectious diseases including asthma as well as infectious diseases could be the causes in acute cough without abnormal findings on the chest X-ray.

Disease Course of Lower Respiratory Tract Infection With a Bacterial Cause.

Bacterial pathogens are assumed to cause an illness course different from that of nonbacterial causes of acute cough, but evidence is lacking. We evaluated the disease course of lower respiratory tract infection (LRTI) with a bacterial cause in adults with acute cough. We conducted a secondary analysis of a multicenter European trial in which 2,061 adults with acute cough (28 days' duration or less) were recruited from primary care and randomized to amoxicillin or placebo. For this analysis only patients in the placebo group (n = 1,021) were included, reflecting the natural course of disease. Standardized microbiological and serological analyses were performed at baseline to define a bacterial cause. All patients recorded symptoms in a diary for 4 weeks. The disease course between those with and without a bacterial cause was compared by symptom severity in days 2 to 4, duration of symptoms rated moderately bad or worse, and a return consultation. Of 1,021 eligible patients, 187 were excluded for missing diary records, leaving 834 patients, of whom 162 had bacterial LRTI. Patients with bacterial LRTI had worse symptoms at day 2 to 4 after the first office visit (P = .014) and returned more often for a second consultation, 27% vs 17%, than those without bacterial LRTI (P = .004). Resolution of symptoms rated moderately bad or worse did not differ (P = .375). Patients with acute bacterial LRTI have a slightly worse course of disease when compared with those without an identified bacterial cause, but the relevance of this difference is not meaningful.

A A common symptom in primary health care: The cough

Cough is the common symptom consulted by primary health care providers. Although treatment of cough is usually simple, healing period could be longer if it diagnosed wrong. Basicly cough divide into two groups; acute and chronic. While the most common cause of acute cough is upper respiratory tract infections, causes of chronic cough are allergic rihinitis, chronic sinusitis, asthma and gastroeosefageal reflux diseases. Nonetheless cough could be the clinical evidence of highly mortal diseases like pulmonary embolism, tuberculosis and lung cancer. Consequently patients with cough symptom must be evaluated delicately and essential follow up protocol must be planned by primary health care providers.

PCR based bronchoscopic detection of common respiratory pathogens in chronic cough: a case control study

BackgroundViral respiratory tract infection is the most frequent cause of acute cough and is reported at onset in about one third of patients with chronic cough. Persistent infection is therefore one possible explanation for the cough reflex hypersensitivity and pulmonary inflammation reported in chronic cough patients.MethodsBronchoscopic endobronchial biopsies and bronchoalveolar lavage cell counts were obtained from ten healthy volunteers and twenty treatment resistant chronic cough patients (10 selected for lavage lymphocytosis). A screen for known respiratory pathogens was performed on biopsy tissue. Chronic cough patients also underwent cough reflex sensitivity testing using citric acid.ResultsThere was no significant difference in incidence of infection between healthy volunteers and chronic cough patients (p = 0.115) or non-lymphocytic and lymphocytic groups (p = 0.404). BAL cell percentages were not significantly different between healthy volunteers and chronic cough patients without lymphocytosis. Lymphocytic patients however had a significantly raised percentage of lymphocytes (p < 0.01), neutrophils (p < 0.05), eosinophils (p < 0.05) and decreased macrophages (p < 0.001) verses healthy volunteers. There was no significant difference in the cough reflex sensitivity between non-lymphocytic and lymphocytic patients (p = 0.536).ConclusionsThis study indicates latent infection in the lung is unlikely to play an important role in chronic cough, but a role for undetected or undetectable pathogens in either the lung or a distal site could not be ruled out.Trials registrationCurrent Controlled Trials ISRCTN62337037 & ISRCTN40147207

Acute cough

Acute cough

Acute cough

An acute cough is defined as lasting less than 3 weeks. Unlike prolonged cough and chronic cough defined in the next chapter, the aetiology of acute cough in these guidelines includes diseases characterized by abnormal findings on physical examination and CXR. In general, acute cough is self-limiting, and many patients simply buy cough remedies over-the-counter without seeing a physician. Thus, more so than in chronic cough, the incidence of acute cough is unknown. However, based on sales of over-the-counter cold remedies and cough preparations, acute cough is a common symptom in many people. Figure 1.1 depicts changes in the incidence of the cause of coughing based on duration of symptoms. The most common cause of acute cough is infection, in particular, the so-called ‘common cold’ due to viral infection of the upper respiratory tract from the nasal passages to the larynx.1 In most cases, these resolve on their own without specific treatment. As duration of symptoms increases to a persistent or chronic cough, it is more likely that the cause is non-infectious. In the differential diagnosis of acute cough, however, it is essential not to miss a potentially life-threatening condition such as pulmonary embolism or acute cardiac failure. Therefore, a detailed history, physical examination, and if necessary, CXR should be performed. Another important point is that all prolonged and chronic coughs first start out as acute coughs, so when diagnosing an acute cough, the causes of persistent and chronic coughs must also be kept in mind. Figure 3.1 outlines the differential diagnosis of acute cough. In Table 3.1, the main causes of acute cough identified in these guidelines are shown. Outline of acute cough. ACE, angiotensin converting enzyme; GERD, gastro-oesophageal reflux disease.

Concept and use of the guidelines

Cough is one of the most frequent complaints for which patients seek medical care throughout the world.1 The exact prevalence of cough in Japan is unknown, but in the UK, 10–15% of the entire population have a daily cough,2 and in the USA, over 100 million dollars are spent each year on treatment of cough.3 The aetiology of cough ranges from the self-resolving common cold to life-threatening cardiac disease and lung cancer. Even if the underlying disease has a good prognosis, the energy expended due to cough decreases patient quality of life (QOL). In addition to being a discomfort for patients, cough due to severe acute respiratory syndrome (SARS) and tuberculosis spreads the risk of infection to family, friends and associates. The presence of rhonchi or rales on physical examination or abnormal findings on CXR makes the diagnosis of cough relatively easy, but in the absence of these findings, many patients may complain of a cough for several weeks without a diagnosis. A recent increase in patients with unexplained cough has been noted both by generalists and specialists in pulmonary medicine. Physicians often focus on symptomatic treatment of cough, but suppression of a productive cough with copious sputum production or cough due to aspiration may worsen the patient’s condition.4 For this reason, the Japanese Respiratory Society has decided to publish the ‘Cough Guidelines’. These guidelines broadly define cough based on duration as acute cough lasting less than 3 weeks, prolonged cough lasting 3–8 weeks and chronic cough lasting longer than 8 weeks. The guidelines are also divided into general and special topics. The special topics include acute cough, prolonged and chronic cough and cough in specific populations (paediatric patients, elderly patients and patients with underlying disease). The authors include paediatricians, internists and ENT specialists. Figure 1.1 shows the incidence of aetiology of cough for each period defined in the guidelines. The most common cause of acute cough is respiratory tract infection, whereas prolonged and chronic coughs of longer duration are more likely due to a non-infectious cause. A consensus report on cough published in the USA has been used in Japan, but many clinicians believe that underlying disease prevalence differs between patients with cough in Japan and Western countries.5 For example, of the three main causes of chronic cough in Western countries,5 cough-variant asthma, postnasal drip and gastro-esophageal reflux disease (GERD), the latter two are not as prevalent in Japan. Duration of symptoms and incidence of cough due to infection. Therefore, these guidelines are not necessarily based on reports from Western countries, but are rather designed specifically for Japan. Cough is a common symptom, and the true value of these guidelines is that they are intended not only for pulmonary specialists, but also for the many generalist physicians who provide front-line care for most of these patients. For disorders presenting with persistent or chronic cough, these guidelines offer both simplified diagnostic criteria that can be used in general clinics where special tests are not needed, as well as more stringent diagnostic criteria requiring special tests that can only be performed in larger general or university hospitals with departments of pulmonary medicine. These guidelines are aimed at the differential diagnosis and treatment of common disorders seen in clinical practice. They are not all-inclusive of some rarer diseases usually found only in textbooks. These guidelines do not limit or impose specific treatment recommendations. We have written these guidelines based on the most reliable data currently available, but in some cases a better means of diagnosis or treatment may be available. We welcome comments and suggestions from those using these guidelines to make future editions more relevant and useful. Our intent is to improve QOL in the many patients who suffer from cough.

Chronic Cough Due to Acute Bronchitis: ACCP Evidence-Based Clinical Practice Guidelines

Background:The purpose of this review is to present the evidence for the diagnosis and treatment of cough due to acute bronchitis and make recommendations that will be useful for clinical practice. Acute bronchitis is one of the most common diagnoses made by primary care clinicians and emergency department physicians. It is an acute respiratory infection with a normal chest radiograph that is manifested by cough with or without phlegm production that lasts for up to 3 weeks. Respiratory viruses appear to be the most common cause of acute bronchitis; however, the organism responsible is rarely identified in clinical practice because viral cultures and serologic assays are not routinely performed. Fewer than 10% of patients will have a bacterial infection diagnosed as the cause of bronchitis. The diagnosis of acute bronchitis should be made only when there is no clinical or radiographic evidence of pneumonia, and the common cold, acute asthma, or an exacerbation of COPD have been ruled out as the cause of cough. Acute bronchitis is a self-limited respiratory disorder, and when the cough persists for > 3 weeks, other diagnoses must be considered.Methods:Recommendations for this review were obtained from data using a National Library of Medicine (PubMed) search dating back to 1950, which was performed in August 2004. The search was limited to literature published in the English language and human studies, using search terms such as “cough,” “acute bronchitis,” and “acute viral respiratory infection.”Results:Unfortunately, most previous controlled trials guiding the treatment of acute bronchitis have not vigorously differentiated acute bronchitis and the common cold, and also have not distinguished between an acute exacerbation of chronic bronchitis and acute asthma as a cause of acute cough. For patients with the putative diagnosis of acute bronchitis, routine treatment with antibiotics is not justified and should not be offered. Antitussive agents are occasionally useful and can be offered as therapy for short-term symptomatic relief of coughing, but there is no role for inhaled bronchodilator or expectorant therapy. Children and adult patients with confirmed and probable whooping cough should receive a macrolide antibiotic and should be isolated for 5 days from the start of treatment; early treatment within the first few weeks will diminish the coughing paroxysms and prevent spread of the disease; the patient is unlikely to respond to treatment beyond this period.Conclusion:Acute bronchitis is an acute respiratory infection that is manifested by cough and, at times, sputum production that lasts for no more than 3 weeks. This syndrome should be distinguished from the common cold, an acute exacerbation of chronic bronchitis, and acute asthma as the cause of acute cough. The widespread use of antibiotics for the treatment of acute bronchitis is not justified, and vigorous efforts to curtail their use should be encouraged.

Cough and the Common Cold: ACCP Evidence-Based Clinical Practice Guidelines

Objective:To review the literature on cough and the common cold.Methods:MEDLINE was searched through May 2004 for studies published in the English language since 1980 on human subjects using the medical subject heading terms “cough” and “common cold.” Selected case series and prospective descriptive clinical trials were reviewed. Additional references from these studies that were pertinent to the topic were also reviewed.Results:Based on extrapolation from epidemiologic data, the common cold is believed to be the single most common cause of acute cough. The most likely mechanism is the direct irritation of upper airway structures. It is also clear that viral infections of the upper respiratory tract that produce the common cold syndrome frequently produce a rhinosinusitis. In the setting of a cold, the presence of abnormalities seen on sinus roentgenograms or sinus CT scans are frequently due to the viral infection and are not diagnostic of bacterial sinus infection.Conclusion:Cough due to the common cold is probably the most common cause of acute cough. In a significant subset of patients with “postinfectious” cough, the etiology is probably an inflammatory response triggered by a viral upper respiratory infection (ie, the common cold). The resultant subacute or chronic cough can be considered to be due to an upper airway cough syndrome, previously referred to as postnasal drip syndrome. This process can be self-perpetuating unless interrupted with active treatment.

Acute cough in the elderly: aetiology, diagnosis and therapy.

Although the frequency of physician consultations and the sale of over-the-counter remedies establish the high prevalence of acute cough in the elderly, epidemiological studies have tended to be imprecise. However, respiratory tract infections in nose, larynx and/or bronchi, either viral or bacterial or both, are by far the commonest cause of acute cough. These are especially frequent and hazardous in the elderly, and community living and institutionalisation may aggravate this problem. A variety of viruses and bacteria have been incriminated, with rhinovirus, influenza and respiratory syncytial viruses, and Streptococcus pneumoniae, Haemophilus influenza and Bordetella pertussis being especially important. Viral infections can readily lead to community-acquired pneumonia. Successful diagnosis should point to successful treatment, and in this respect clinical examination and patient history are paramount, supplemented by chest X-ray, viral and bacterial culture and serological testing. Depending on the results of these tests, specific antibacterial therapy may be called for, although there is dispute as to the merits of antibacterial therapy in cases of uncertain diagnosis. Prevention and prophylaxis for influenza and S. pneumoniae infections are now commendably routine in the elderly, especially those in communities. Treatment, as well as the use of antibacterials, may also be directed against the inflammatory and infective processes in the airways. Non-specific antitussive therapy is common and usually highly desirable to prevent the adverse effects of repeated coughing. There have been few advances in antitussive therapy in recent years, opioids and dextromethorphan being the most commonly used agents; they act centrally on the brainstem, but also have a large placebo effect. However they work, they are much appreciated by patients and their partners. Moreover, striking advances in our understanding of the peripheral sensory and central nervous pathways of the cough reflex in recent years should soon lead to a new and more specific choice of agents to inhibit cough.

Diagnosis and Management of Acute Bronchitis and Pneumonia in the Ambulatory Setting

Acute bronchitis and pneumonia are frequently encountered by primary care providers in an outpatient setting. The primary care nurse practitioner plays an active role in the diagnosis and management of acute bronchitis and pneumonia. Certain elements of the history and physical examination help separate infectious causes of acute cough from non-infectious causes. If an infectious cause is established by etiology, history and physical factors also help to identify whether acute bronchitis or pneumonia is present. Certain diagnostic tests are necessary to aid in making the diagnosis and in establishing the causative agent upon which the appropriate therapy is based. The primary care nurse practitioner must also be attuned to identifying those clients in whom respiratory illness can be a severe syndrome necessitating hospitalization and those for whom vaccination is recommended. This article addresses the practice needs of the clinician.