Cough history and symptoms

Making a list of differential diagnosis when a patient presents with a cough can be challenging; however, the clinician should take a detailed cough history. To do this successfully, the clinician must ask himself the following:

• How to classify the cough based on the duration of symptoms.
• What are some of the additional questions to as about the cough.
• What are the red flags in this patient.

A detailed cough history should cover the following:

• Onset of symptoms.
• Dry vs Productive cough.If productive,sputum content,color,amount etc.
• Duration.
• Exacerbating/relieving factors.
• Previous episodes.
• Frequency.
• Drug use eg:ACEIs

• Fever:If a fever is present the clinician should consider the cough to be infectious or neoplastic in origin.
• Chills and Rigor: while chills are non specific signs,rigors could suggest bacteremia or viremia.
• Weight loss: This is a red flag and it could suggest an underlining malignancy or ]]infection]] eg Tuberculosis.
• wheezing: The presence of wheezing could suggest bronchial asthma.
• Associated Hemoptysis.
• Post nasal dripping: Postnasal drip is a prevalent cause of cough.
• Allergy history: Patients with seasonal allergies are prone to coughing.
• Smoking history: A detailed smoking history should be taken.
• Environmental or Occupational exposure to air pollutants.

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