Cause |
Accompanying signs and symptoms, cough characteristics, sputum production |
Asthma or (much less often) eosinophilic bronchitis |
Attack of cough may be triggered by exposure to specific or nonspecific factors, such as allergens, cold air, exercise; cough often occurring at night; accompanied by dyspnea and wheezing; good response to bronchodilators and inhaled glucocorticoids; mucous sputum, may be yellowish (high eosinophil content) |
Gastroesophageal reflux |
Most often accompanied by heartburn and other dyspeptic symptoms, but GI symptoms may be absent; sometimes accompanied by hoarseness or dysphonia; improved by PPI and H2 antagonist treatment (2-month treatment recommended) |
Postnasal drip |
Chronic rhinitis with postnasal drip; often history of allergy; concomitant chronic sinusitis; most frequently mucous sputum; “cobblestone” pattern of posterior pharyngeal mucosa |
Chronic bronchitis or COPD |
History of smoking and frequent respiratory tract infections; most severe in the morning and immediately after waking up; often resolves on expectoration of mucous secretions |
Bronchiectasis |
Copious amounts of expectorated sputum (especially in the morning), often purulent, yellow and green |
ACEI |
Dry cough resolving after drug discontinuation, although in some cases may persist for several months |
Pneumonia, lung abscess, tuberculosis, sarcoidosis, tumors |
Manifestations of underlying condition depending on its severity |
Left ventricular failure, mitral stenosis, aortic aneurysm compressing trachea or bronchi |
Usually attacks of dry cough at night; may be accompanied by wheezing; pink frothy secretions in patients with pulmonary edema; considerably enlarged left atrium or dilated pulmonary artery may compress recurrent laryngeal nerve and cause hoarseness |
Chronic idiopathic cough |
No cause identified but attributed to cough hypersensitivity syndrome; commonly triggered by strong smells, perfumes, aerosols, change in temperature, talking, laughing, and singing; symptoms of irritation of throat and chest |
ACEI, angiotensin-converting enzyme inhibitor; COPD, chronic obstructive pulmonary disease; GI, gastrointestinal; PPI, proton pump inhibitor. |