How did the cough start? | | Very acute onset | | Retained inhaled foreign body |
| Head cold | | Infective cause (eg, postviral) |
When did the cough start? | | Neonatal onset (especially if in first few days of life) | | Aspiration |
| | Congenital malformation |
| | Cystic fibrosis |
| | Primary cilial dyskinesia |
| | Lung infection in utero |
What is the quality of the cough? | | Productive (“moist or wet”) | | Chronic suppurative lung disease (bronchiectasis) eg, cystic fibrosis |
| Paroxysmal spasmodic cough with or without an inspiratory “whoop” and vomit | | Pertussis or pertussis-like illness |
| Haemoptysis | | Cystic fibrosis |
| | Other bronchiectasis |
| | Retained inhaled foreign body |
| | Tuberculosis |
| | Tumour |
| | Pulmonary haemosiderosis |
| | Pulmonary arteriovenous malformation |
| “Bizarre honking cough” in a child exhibiting “la belle indifference” to the cough and which increases with attention | | Psychogenic cough |
| Dry repetitive cough, disappears with sleep | | Habit cough |
| Brassy, barking or “seal-like” | | Tracheal or glottic cause (eg, tracheomalacia and/or bronchomalacia) |
| Cough producing casts of the airways | | Plastic bronchitis |
Is the cough relentlessly progressive? | | | | Inhaled foreign body |
| | Lobar collapse |
| | Tuberculosis |
| | Rapidly expanding intrathoracic lesion |
Is the cough an isolated symptom? | | Isolated cough (otherwise well) | | Non-specific isolated cough |
| | | Recurrent viral bronchitis |
| | | Psychogenic cough |
| Associated wheezing present | | Asthma |
| | | Retained inhaled foreign body |
| | | Recurrent pulmonary aspiration |
| | | Airways compression or tracheobronchomalacia |
| | | Bronchiolitis obliterans or interstitial lung disease |
| | | Neonatal chronic lung disease and rarely |
| | | Cardiac disease with either congestive heart failure or large left to right shunts |
| Associated ill health, recurrent pneumonia or pulmonary infiltrates | | Cystic fibrosis |
| | Immune deficiencies |
| | Primary cilial disorders |
| | Recurrent pulmonary aspiration |
| | Retained inhaled foreign body |
| | Tuberculosis |
| | Persistent bacterial bronchitis |
| | Anatomical disorder |
| Associated shortness of breath and restrictive lung defect | | Interstitial lung disease |
What triggers the cough? | | Exercise, cold air, early morning | | Asthma |
| Lying down | | Postnasal drip, gastro-oesophageal reflux disease |
| Feeding | | Recurrent pulmonary aspiration |