How Can Persistent Cough In A Child Be Treated?

Posted on Sat, 6 May 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 6 May 2017 Answered on

Mon, 29 May 2017 Last reviewed on

Question : MY DAUGHTER IS 14 Y/O AND HAS HAD A COUGH SINCE APRIL 14TH. IT STARTED AS FOLLOWS - SHE WAS PARTICIPATING IN A TRACK MEET WHEN IT WAS 34 DEGREES, WINDY AND SNOW SHOWERS. THE NEXT DAY SHE STARTED WITH A COUGH NON PRODUCTIVE, SCRATCHY THROAT AND RUNNY NOSE. I STARTED HER ON OTC COUGH MEDICINE. WAITED THIS OUT FOR 2 WEEKS, WHEN THE SCRATHY THROAT AND RUNNY NOSE HAVE SINCE GONE. BUT SHE HAS THIS PERSISTANT COUGH THAT HAS GOTTEN WORSE. IT IS NON PRODUCTIVE. ON APRIL 23RD I TOOK HER TO URGENT CARE FOR THE COUGH. DOCTOR SAID IT WAS ALLERGIES AND SAID TO GIVE OTC ZYRTEC D 2/DAY, FLONASE X2/DAY. ON APRIL 28TH TOOK HER TO HER DOCTOR AND HAD HER DOCTOR HAD HER DO A METHOCHOLINE CHALLENGE, DOCTOR HAD HER STARTED ON PREDNISONE 10MG 1/DAY FOR 5 DAYS AND USE A PROAIR INHALER Q 4 HRS PRN UNTIL WE RECEIVED THE TEST RESULTS. SHE TOOK THE 5 DAYS OF PRENISONE AND USE PROAIR WITH NO CHANGE. THIS DID NOT WORK AND THE DOCTOR WAS RECONTACTED. THE PRENISONE WAS INCREASED TO 20MG 1/DAY FOR 5 DAYS AND CONTINUE TO USE PROAIR. TEST RESULTS SHOW THAT SHE HAS ASTHMA. SHE WAS STARTED ON ADVAIR 100MG TWICE A DAY. HAS BEEN DOING THIS SINCE MAY 3RD AND NO CHANGES. HER COUGH IS WORSE TO THE POINT THAT SHE IS VOMITING WITH THE COUGH. NO FEVER. I AM A PARAMEDIC FOR 30 YEARS. THIS DOES NOT SEEM LIKE ASTHMA AND I DO NOT HEAR ANY WHEEZING AT ALL WITH THESE EPISODES. IT SEEMS TO ME LIKE HER LARYNX IS SPASMING.

Answered by Dr. Diptanshu Das (1 hour later)

Brief Answer:
Steam inhalation is the mainstay of treatment.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through carefully the details and understand your concern.

Most often such symptoms are due to viral infections and antibiotics are ineffective in such cases.

Irrespective of treatment it usually spontaneously resolves in 5-7 days. Some children are more prone to catching cold and recurrent episodes are seen. Often such viral infections manifest with fever. Such infections are frequently associated with an allergic component and the elevation in Immunoglobulin (possibly IgE) confirms this propensity.

This does not mean that it is asthma. However, bronchospasm or laryngospasm may be found at times. Zyrtec and Flonase are the right medicines to be given. Prednisolone is given only in severe cases. The ProAir inhaler can also be used.

However, I would insist on steam inhalation. Water vapor will reach deep inside and would help in diluting the cough and thus would provide relief.

Montair LC (montelukast + levocetirizine) is better than Zyrtec but is a prescription medicine that can be used.

Please be patient. It may take a few days for the recovery to occur.

Feel free to write back in case of any further queries.

Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee