Seasonal running nose & flu like symptoms

A male child 10years old complaining about recurrent cough and cold after taking cold drinks or sudden change in environment. what should be the diagnosis

IDIOPATHIC COUGH Chronic cough by definition is a cough that lasts eight weeks or longer in adults, or four weeks in children. Cause for cough could be determined successfully in up to 98% of cases and is mostly due to either cough variant asthma (CVA), rhinosinusitis associated with postnasal drip syndrome (PNDS) or gastro-oesophageal reflux disease (GORD) There are many other common causes of chronic cough like Asthma, copd, ild, lung cancer, non resolving pneumonia, Bronchiectasis, pulmonary eosinophila, pl effusion, pneumoconisis, hypersensitive pneumonitis, cardiac involvement etc. But diagnosis is obvious in most cases. IDIOPATHIC COUGH In patients whom none of the usual explanations for cough may be present even after thorough diagnostic work up. Patients with unexplained chronic cough are predominantly female (77%) and are eight times more likely to have an organ-specific autoimmune disease, particularly hypo-thyroidism. Idiopathic cough is associated with air-way inflammation. The levels of several tussive media- tors, including cysteinyl-leukotrienes, histamine, prostaglandin D2 and E2, have been shown to be elevated in induced sputum in these patients Typically the female patients are of peri- or post menopausal age, report a preceding upper respiratory tract infection (URTI) and have a heightened cough reflex to tussive stimuli. TREATMENT Idiopathic cough should be treated with safer cough suppressants like dexromethorphan in higher doses (60 mg per day). It may need to be continued for a longer period. I hope this information will be HELPFUL to your clinical practice.

13yrs old boy with h/o recurrent nasal bleeding. h/o heat intolerance, since birth. spot diagnosis and kindly give opinion about management

12 years boy 27 kg C/o dry cough since 1.5 months loss of apetite RS wheez bl wbc 11100 esr 45 neutrophils 70% plz dx and rx

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…..