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Chronic cough

The duration of cough exceeds 3 weeks (for acute cough click here)

Does it meet the criteria for COPD? 3 months for 2 yrs.

If not COPD then request a chest x-ray.

1.Chest x-ray shows an abnormality:

• Nodular infiltrate
  Perform a biopsy: nodules could be malignant, fungal or a benign tumor.

• Diffuse infiltrate
  Request sputum / tissue culture analysis:

  • Analysis results positive: pneumonia

  • Analysis results negative: sarcoidosis, interstitial fibrosis, aspiration pneumonia, foreign body

2. Chest x-ray doesn't show any abnormalities:

• Examine patient for symptoms and signs of infection

  - History & physical indicate infection: consider bronchitis, sinusitis, pharyngitis.

  - History & physical do not indicate infection:
  

  • Request Pulmonary function tests (PFT)

  • PFT results are positive: possible results are obstructive pulmonary disease: asthma, airway compression

  • PFT results are negative: possible causes are chronic bronchitis, irritation, reflux and aspiration, postnasal cause, vagus stimulation, irritation of the  pleura / diaphragm, psychogenic

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