Acute cough is the most common new presentation in primary care
In a majority of patients, a medical history and a physical examination is sufficient to differentiate serious conditions from non-life-threatening conditions (2)
Patients with additional chest signs and/or respiratory symptoms like haemoptysis, breathlessness, chest pain, fever, and weight loss should undertake chest radiography to exclude possible serious life-threatening conditions (1)
A normal chest x-ray can be seen in the following patients with acute cough - viral respiratory tract infections (influenza, RSV, rhinovirus), bacterial infections (acute bronchitis), inhaled foreign body, inhaled toxic fumes (1)
Further investigations are indicated in patients with haemoptysis, prominent systemic illness, suspicion of inhaled foreign body and suspicion of lung cancer (1).
Other infective causes of cough include COVID-19, pneumonia, acute exacerbations of asthma, chronic obstructive pulmonary disease or bronchiectasis (which may also be noninfective exacerbations), and viral-induced wheeze, bronchiolitis, croup or whooping cough. Non-infective causes may include lung cancer, a foreign body, interstitial lung disease, pneumothorax, pulmonary embolism, heart failure, use of certain medicines (for example, an angiotensin-converting enzyme inhibitor), upper airway cough syndrome (post-nasal drip), or gastro-oesophagal reflux disease. (6)
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