Postinfectious cough

Postinfectious cough is a clinical condition characterized by a cough that persists for weeks or months following a respiratory tract infection, such as the common cold, influenza, or pneumonia. It is considered a type of chronic cough, which is a cough lasting more than eight weeks in adults and more than four weeks in children. Postinfectious cough is often a source of frustration for both patients and healthcare providers due to its persistent nature and the challenge it presents in terms of management and treatment.

Causes

The exact mechanism behind postinfectious cough is not fully understood, but it is believed to be related to inflammation and damage to the airways that persists even after the initial infection has resolved. This ongoing inflammation can sensitize the airway nerves, leading to an exaggerated cough reflex. Various pathogens, including viruses, bacteria, and atypical organisms, can initiate this process.

Symptoms

The primary symptom of postinfectious cough is a persistent cough that remains after other symptoms of the respiratory infection have resolved. This cough can be dry or productive and is often described as being particularly severe or hacking. It may be accompanied by other symptoms such as postnasal drip, throat clearing, and fatigue, which are residual effects of the initial infection.

Diagnosis

Diagnosis of postinfectious cough is primarily clinical, based on the patient's history and the persistence of cough beyond the expected duration of an acute respiratory infection. Additional tests may be conducted to rule out other causes of chronic cough, such as asthma, gastroesophageal reflux disease (GERD), or chronic obstructive pulmonary disease (COPD). These tests can include chest X-rays, spirometry, and sometimes bronchoscopy.

Treatment

Treatment of postinfectious cough focuses on symptom management and may include the use of cough suppressants, inhaled corticosteroids, or bronchodilators. However, evidence regarding the effectiveness of these treatments is limited, and they may not work for everyone. In many cases, the cough will resolve on its own over time. Patients are also advised to avoid cough triggers, such as tobacco smoke and other irritants.

Prevention

Preventing the initial respiratory infection is key to avoiding postinfectious cough. Measures such as regular handwashing, avoiding close contact with sick individuals, and staying up to date with vaccinations can reduce the risk of respiratory infections and, consequently, postinfectious cough.