GPAtlas🧭 When to suspect
An acute cough is one lasting less than 3 weeks.
• In children it is usually a symptom of a self-limiting viral upper respiratory tract infection (URTI).
• Most affected children are systemically well, need no investigation and no antibiotic, and recover within a fortnight or so.
• The cough itself can linger for up to 3 weeks.
• Confidently recognise the well child with a simple viral cough – who needs explanation, supportive care and safety-netting.
• But never miss the smaller number with a serious cause, chiefly pneumonia, bronchiolitis, croup, an inhaled foreign body, or, increasingly in the UK again, whooping cough.
• A sudden-onset cough in a previously well toddler should always raise the possibility of an inhaled foreign body.
| Likely cause (typical age) | Distinguishing features |
|---|---|
| Viral URTI (any age) | • Coryza, sneezing and a mild cough in a well child • Little or no fever • Settles within around 3 weeks |
| Community-acquired pneumonia (any age) | • Fever (often ≥38.5°C), tachypnoea, increased work of breathing and focal chest signs (bronchial breathing or localised crackles) • May have chest or abdominal pain |
| Bronchiolitis (under 1 year; peak 3–6 months) | • Coryzal prodrome, then cough, wheeze and fine bilateral crackles, with feeding difficulty and respiratory distress • Usually respiratory syncytial virus (RSV) in winter |
| Viral-induced wheeze (6 months–5 years) | • Wheeze occurring only with viral infections, with no symptoms between episodes • A distinct entity from asthma |
| Croup (6 months–3 years) | Barking, seal-like cough with stridor and a hoarse voice, typically worse at night following a coryzal prodrome. |
| Inhaled foreign body (any; usually toddlers) | • Sudden onset, often with a choking episode • May have unilateral wheeze or reduced air entry • Symptoms can fluctuate |
| Whooping cough (pertussis) (any; most dangerous in young infants) | • Paroxysmal coughing fits, an inspiratory "whoop", post-tussive vomiting, and apnoea or colour change in young infants • Consider during the current UK resurgence |
Source: NICE NG143 · British Thoracic Society · UKHSA
🔒 Sign up free to read the full topic
You're viewing a free preview. Create a free account to unlock the rest.
Sign up free →Sample topics are open to everyone in the Free Sample Bundle.