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10 Minute consultation: Acute cough in children

BMJ 2004; 328 doi: https://doi.org/10.1136/sbmj.0406236 (Published 01 June 2004) Cite this as: BMJ 2004;328:0406236
  1. Alastair D Hay, clinical lecturer in primary health care1,
  2. Knut Schroeder, clinical lecturer in primary health care1,
  3. Tom Fahey, professor of primary care medicine2
  1. 1Division of Primary Health Care, University of Bristol, Bristol BS6 6JL
  2. 2Tayside Centre for General Practice, University of Dundee, Dundee DD2 4AD

A previously well boy of 24 months is brought in by his mother in February. For 10 days he has had worsening cough, fever, and coryza. Both parents have asthma, and his mother is worried that he too might have asthma.

What issues you should cover

  • Are the boy's symptoms due to serious or mild illness? Associated symptoms such as shortness of breath, wheeze, reduced fluid intake, dehydration, fever, and reduced activity and social interaction indicate a more severe illness.

  • What is the cause? Making an exact diagnosis of cough can be difficult, but useful pointers include the part of the respiratory tract that is most affected, the season, and pattern recognition. At least 90% of children with cough have a respiratory tract infection such as a cold, croup, bronchitis, bronchiolitis, whooping cough, or pneumonia. The peak incidence of cough in January and February is eight times higher than the trough in August. Epidemics of croup tend to …

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