Suggest Treatment For Persistent Severe Cough

Posted on Sat, 25 Oct 2014

Question: my son age 10, has been coughing for more than a month now, he doesn't cough when he is asleep only when he is awake. we tried post nasal drip treatment with PSE but no improvement and we have been giving him Claritin, yet no improvement, he was treated for pneumonia with Z-pack about 3 weeks ago, but he is still coughing with no fever so what could be the problem?
Thanks and hope to hear from you

Answered by Dr. Irshad H Naqvi (42 minutes later)

Brief Answer:
allergic cough,

Detailed Answer:
Hi Dear
Welcome to the HCM,
One month old cough to be treated with some antihistaminic decongestant (CPM phenylepherine)and bronchodilaitors as nebulized and oral form of salbutamol.
This long cough should also be investigated in terms of CBC, ESR, AEC. CXR to rule out any acute or chronic infection in the chest, Eosinophilia etc and accordingly baby may be treated.
Hope the query is answered.
Please feel free for the further clarification.
Thanks

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Irshad H Naqvi (1 hour later)

Thanks Dr Nagvi,
My son tells me that he does not have nasal congestion or post nasal drip per se, according to him the "mucus" or a "mucus like" something gets stocked around his throat and therefore led to repeated effort to cough it out but ironically he doesn't cough while asleep. He has also been sneezing lately and we have treated him for allergies in the past mostly around spring. Do you think he might have a mild form of Asthma? And what test need to be carried out to confirm diagnosis of asthma? Do you think he might need a chest x-ray too? And do you think treatment with a steroid inhaler might help too in addition to the salbutamol inhaler you suggested?
thanks

Answered by Dr. Irshad H Naqvi (21 hours later)

Brief Answer:
CXRay is important.combined inhalers

Detailed Answer:
Hi Dear
I have already emphasised upon the the importance of investigations like AEC ( absolute eoisinophil count), CBC(complete blood count), ESR, CXR( chest x ray) to get the exact diagnosis and also to rule out any subtle infection or any intangled foreign body in the chest.
Though all Symptoms fit in to allergic phenonmenon in the system, leading to persistant cough, sneezing and post nasal secretions etc.
Inhaled corticosteroids (ICS) along with the salbutamol /ot the nebulized form will definately help in the alleviating the symptoms of allergic bronchospasm and prolonged cough.
Hope the query is answered.
It will be easier to make diagnosis if you please upload all the investigation report in the further follow up query.
Thanks

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj