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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Congenital esophageal atresia (EA) and/or tracheoesophageal fistula (TEF) are common congenital anomalies. Respiratory and GI complications occur frequently, and may persist lifelong. Late complications of EA/TEF include tracheomalacia, a recurrence of the TEF, esophageal stricture, and gastroesophageal reflux. These complications may lead to a brassy or honking-type cough, dysphagia, recurrent pneumonia, obstructive and restrictive ventilatory defects, and airway hyperreactivity. Aspiration should be excluded in children and adults with a history of EA/TEF who present with respiratory symptoms and/or recurrent lower respiratory infections, to prevent chronic pulmonary disease.
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PMID:Long-term complications of congenital esophageal atresia and/or tracheoesophageal fistula. 1536 74

Two girls developed symptoms of wheezing which started shortly after birth. The symptoms did not respond to bronchodilators. At the age of 5 months, the first infant developed severe respiratory distress with decreased left-sided breathing sounds on auscultation. The chest X-ray showed left-sided hyperinflation. Bronchoscopy revealed isolated malacia of the left main stem bronchus. The second patient, who had a history ofcor vitium, was referred to a paediatric pulmonologist in an academic hospital for chronic coughing and wheezing. Bronchoscopy and CT angiogram, performed at the age of 14 months, revealed tracheal malacia due to compression from a right descending aortic arch. Broncho- and tracheomalacia are disorders which may rarely result in severe respiratory distress. These disorders should be considered when unexplained symptoms of wheezing or coughing are present in young infants, especially if the symptoms start shortly after birth and persist without signs of viral infection.
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PMID:[Wheezing and cough related to congenital airway abnormalities in young infants]. 1720 3

Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.
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PMID:Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma. 1816 77

Children with cough, in particular chronic cough, are sometimes referred to otolaryngologists for assessment, diagnosis, and management. Although the likely diagnoses encountered by otolaryngologists are rhinosinusitis, foreign body aspiration, and tracheomalacia, otolaryngologists should be cognizant of the many other possible diagnoses and the evidence for and against their association. This article highlights and focuses the discussion on the cough issues relevant to otolaryngologists.
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PMID:Cough in the pediatric population. 2017 67

Tracheomalacia is a rare condition involving increased flaccidity of the tracheal cartilage, widening of the posterior membranous wall and a reduced airway calibre. This combination can cause a tracheal collapse, expiratory flow obstruction and decreased clearance of secretions. We present a case of a 70-year-old woman with severe coughing symptoms and obvious tracheomalacia diagnosed with a high resolution computed tomography in the expiratory phase. On a computed tomography, tracheomalacia has an easily recognizable pattern, which is only visible during expiration. Tracheomalacia is probably an underdiagnosed condition.
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PMID:[Tracheomalacia as a cause of chronic cough]. 2266 51

Tracheomalacia (TM) is an under-recognized condition that presents with nonspecific symptoms such as dyspnea, cough, and recurrent infections. Frequently, patients with this condition are misdiagnosed with more prevalent diseases such as asthma and chronic obstructive pulmonary disease. We report a case of a 29-year-old woman with long-standing, mild, persistent asthma characterized by dyspnea and cough, who experienced acute and severe worsening of her symptoms after the cesarean section for the delivery of her third child. She was initially treated with bronchodilators and oral corticosteroids without improvement. She underwent further evaluation with a chest computed tomographic scan and a flexible bronchoscopy, which revealed focal TM in the distal trachea secondary to chronic extrinsic compression due to a pulmonary vascular sling. We discuss her subsequent evaluation and management.
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PMID:Pulmonary artery sling: a rare cause of tracheomalacia in the adult. 2320 75

The authors report the case of a 6-year-old girl, presenting with a 4-month history of wheeze associated with barking cough which frequently became wet requiring antibiotics. Her care was transferred to a paediatrician with specialist interest in paediatric respiratory medicine when she had continued symptoms despite bronchodilators and oral steroids for suspected asthma. Spirometry showed a forced expiratory volume 1 of 79% with no evidence of reversibility. The child was investigated for chronic wet cough. Immunoglobulins, sweat test and chest x-ray were all normal. There was no history suggestive of foreign body aspiration (FBA). Tracheomalacia was considered in view of the nature of the cough. The recurrence of an unusual inspiratory noise prompted referral for bronchoscopy. A small piece of plastic tube was removed from the bronchus intermedius. All symptoms resolved. The importance of clinical assessment to ascertain 'wheeze' when acutely unwell is emphasised. Current literature concerning FBA is reviewed.
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PMID:All that wheezes is not asthma: a 6-year-old with foreign body aspiration and no suggestive history. 2323 18

BACKGROUND Tracheomalacia, a disorder of the large airways where the trachea is deformed or malformed during respiration, is commonly seen in tertiary paediatric practice. It is associated with a wide spectrum of respiratory symptoms from life-threatening recurrent apnoea to common respiratory symptoms such as chronic cough and wheeze. Current practice following diagnosis of tracheomalacia includes medical approaches aimed at reducing associated symptoms of tracheomalacia, ventilation modalities of continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP), and surgical approaches aimed at improving the calibre of the airway (airway stenting, aortopexy, tracheopexy). OBJECTIVES To evaluate the efficacy of medical and surgical therapies for children with intrinsic (primary) tracheomalacia. METHODS Search The Cochrane Airways Group searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Airways Group's Specialized Register, Medline and Embase databases. The Cochrane Airways Group performed the latest searches in March 2012. Selection criteria All randomized controlled trials (RCTs) of therapies related to symptoms associated with primary or intrinsic tracheomalacia. Data collection and analysis Two reviewers extracted data from the included study independently and resolved disagreements by consensus. MAIN RESULTS We included one RCT that compared nebulized recombinant human deoxyribonuclease (rhDNase) with placebo in 40 children with airway malacia and a respiratory tract infection. We assessed it to be a RCT with overall low risk of bias. Data analyzed in this review showed that there was no significant difference between groups for the primary outcome of proportion cough-free at two weeks (odds ratio (OR) 1.38; 95% confidence interval (CI) 0.37 to 5.14). However, the mean change in night time cough diary scores significantly favoured the placebo group (mean difference (MD) 1.00; 95% CI 0.17 to 1.83, P = 0.02). The mean change in daytime cough diary scores from baseline was also better in the placebo group compared to those on nebulized rhDNase, but the difference between groups was not statistically significant (MD 0.70; 95% CI -0.19 to 1.59). Other outcomes (dyspnoea, and difficulty in expectorating sputum scores, and lung function tests at two weeks also favoured placebo over nebulized rhDNase but did not reach levels of significance. AUTHORS' CONCLUSIONS There is currently an absence of evidence to support any of the therapies currently utilised for management of intrinsic tracheomalacia. It remains inconclusive whether the use of nebulized rhDNase in children with airway malacia and a respiratory tract infection worsens recovery. It is unlikely that any RCT on surgically based management will ever be available for children with severe life-threatening illness associated with tracheomalacia. For those with less severe disease, RCTs on interventions such as antibiotics and chest physiotherapy are clearly needed. Outcomes of these RCTs should include measurements of the trachea and physiological outcomes in addition to clinical outcomes.
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PMID:Interventions for primary (intrinsic) tracheomalacia in children. 2307 14

The cough reflex is modulated throughout growth and development. Cough-but not expiration reflex-appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children. Prolonged acute cough is usually related to the long-lasting effects of a previous viral airway infection or to the particular entity called protracted bacterial bronchitis. Cough pointers and type may orient toward specific etiologies, such as barking cough in croup or tracheomalacia, paroxystic whooping cough in Pertussis. Cough is productive in protracted bacterial bronchitis, sinusitis or bronchiectasis. Cough is usually associated with wheeze or dyspnea on exertion in asthma; however, it may be the sole symptom in cough variant asthma. Thus, pediatric cough has particularities differentiating it from adult cough, so the approach and management should be developmentally specific.
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PMID:What is chronic cough in children? 2522 17

Tracheomalacia remains a special entity present also in children and adults. Tracheomalacia refers to a weakness of the trachea. Bronchoscopy is the "golden standard" for diagnosis. Differential diagnosis includes foreign body aspiration, difficult controlled asthma and other diseases. This disease may be congenital or it may be acquired. Acquired tracheomalacia can be treated. The main symptoms in tracheomalacia are: dyspnea, sputum production, hemoptysis and cough in adults and expiratory stridor and cough in children. Tracheomalacia could be progressive in some patients. We want to bring to your attention the tools for diagnosis and different methods of treatment. Tracheomalacia is not a rare disease and therefore we need to consider it.
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PMID:Tracheomalacia in children and adults--not so rare as expected. 2534 Dec 72


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