POST VIRAL COUGH… Persistent cough lasting >3 weeks following the acute symptoms of an upper or lower respiratory tract viral infection. Such patients are considered to have a subacute cough because the condition lasts for less than 8 weeks. The chest radiograph findings are normal and the cough eventually resolves in most of the cases on its own but in few patients persists…. and lead to unnecessary investigations.. The exact pathogenesis of the post viral cough is not known, But it is thought to be due to…    the extensive inflammation and disruption of upper and/or lower airway epithelial integrity. In lower airway, this is often associated with the accumulation of an excessive amount of mucus hypersecretion There is also transient airway and cough receptor hyperresponsiveness; All of the above pathology contribute to the subacute cough No treatment guidelines are available. Therapy with antibiotics has no role except complicated by bacterial sinusitis The use of inhaled ipratropium may be helpful. Cough suppressant like dexromethorphan should be used to suppress the upper airway component Inhaled corticosteroids with or without bronchodialator may be used for a short period to tackle the bronchial inflammation. Associated gastroesophageal reflux disease, which may be a complication of the vigorous coughing may need treatment. Post viral cough is very common in our clinical practice both in children and adults.. Keeping this diagnosis in D/D and patience is needed in most of the cases.. It saves cost of investigations and treatment… I hope it will be helpful…..

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Thank you sir for posted a very common problem. .pt and doctors both are uncomfortable because of repeated visits due cough. . any chronic cough DD.. 1.GERD 2.POST NASAL DRIP 3.EARLY ONSET OF BRONCHIAL ASTHMA 4.EARLY STAGES OF PULMONARY EDEMA PLZ CORRECT ME SIR.IF ANYTHING WRONG. .THANK YOU SIR

Dear Dr Suresh, you are absolutely correct first three constitutes 90% of chronic cough
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Dr. Arnab.. Not always possible especially in children.. In case of doubt better send throat swab culture... and antibiotics should be added... But In most of the cases of viral fever the total leukocyte count is reduced.. The cough intensity is also usually not as disturbing as in whooping cough..

Thank you so much sir.
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Thank u vm sir. I suffered this every yr. Do not know why. Many a times dextromethorphan not helping much. Very nagging cough.

Advised to get post bdr spirometry done at present and also during the coughing episode... Non smoker i hope..
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very helpful and nice topic sir. we get such pt. but asthma has to be r/ o in such cases. This cough can be worse in very dry environments, and may be triggered by talking or eating. Some patients with a post-viral cough find it helpful to drink plenty of fluids to stay hydrated. Cough lozenges are typically not effective, and measures like steam tents may offer limited comfort. If the cough becomes severe, the patient could have difficulty sleeping or exercising because of the throat irritation. In the event a patient needs more aggressive treatment, the best option is usually a cough syrup that contains codeine. Opioids suppress the cough reflex and can keep a post-viral cough down while the airways recover. Such products need to be used with care and the patient may need to taper off at the end of the course of medication to prevent withdrawal symptoms.

Thanks Dr Akhilesh.. I agree codiiene is the ultimate cough suppressant.. But Dextromethorphan in higher dose like 60 mg per day is effective in most of the patients.. It is a safer option also.. Then at times lower respiratory tract is simultaneously involved.. And contributes to the cough... It needs addition of inhaled drugs to get a desired result.. Thanks again for your interest shown in the topic...
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Thank you so much sir for presenting this topic which is very relevant and common in our day today clinical practice. I would like to know one thing sir , how would one differentiate cough due to Bordetella Pertussis from post viral cough as both these condition share common clinical picture?

Thanks for a very common and troublesome entity named post viral cough. All points are well taken and useful in practice.

Thanks sir for sharing such common topic. Sir will short course of steroids in doses about 0.5 mg /kg will help?

Post viral cough in pregnancy?? Pt complaining cough with breathlessness supress both after taking grilinctus.. HB 8.5 8 month of pregnancy.. H/O viral fever with enteric fever RX taking monocef 1gm bd for 5 dys After iv Zifi 400mg bd 5 dys Azee 500 od for 7 dys Monti lc od PCM sos Rebez D od Any line of RX for cough?

Thank you Sir .we definitely come across such patients in our day to day practice.

Thanks Dr lele for your interest in the topic
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I am a patient of recurrent lost viral cough. Starts with sore throat progress to dry cough for 3 to 4 months. i have tried virtually everything available in modern medicine and also alternate. Even steroids. Nothing helps. However Salmon oil capsules seem to prevent occurance. thus is tume tested. The years i am regular with salmon oil, cough doesnt come. Probably related to anti inflammatore effect of omega 3s. Worth trying. This us time teated by me, over years.

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