Cough

A cough is an explosive forced expiratory manoeuvre, usually against a closed glottis, and gives rise to a characteristic sound. Acute cough is defined as a cough of less than 3 weeks duration, and chronic cough as one of more than 8 weeks duration. Acute cough is the commonest presenting symptom in primary care: by far the most frequent cause is a viral respiratory tract infection. The main effect of coughing is on quality of life and this is particularly prominent in patients with chronic cough, as these frequently develop physical complications such as chest pain, retching and vomiting, hoarseness, incontinence, sleep disturbance, and syncope. In addition, psychological distress and social embarrassment are often features. This chapter covers the approach to diagnosis for acute and chronic cough as well as diagnostic tests, therapies, prognosis, and dealing with uncertainty.