61/m With complained of generalized weakness.since 15 days. mild cough. no h/o fever ,loss of appetite,weight loss. Esr 34 chronic smoker.

Dear Dr. The patient is suffering with dry cough since 2 and half years ago. first the patient suffered from fever and cough with sputum for about 1 month and not taken treatment. after one month the cough became dry cough. -No history of allergies -No history of smoking and drinking =the cough is characterised by: -throat irritation -reddening of face while cough -No sputum -increases in night time, and after food and drinking water too. #consulted 3 doctors and done cxr. doctor told it's due to some allergies and given cough syrups and tablets. # patient is not relieved of dry since then. please kindly do dx And recommend rx.

IDIOPATHIC COUGH Chronic cough by definition is a cough that lasts eight weeks or longer in adults, or four weeks in children. Cause for cough could be determined successfully in up to 98% of cases and is mostly due to either cough variant asthma (CVA), rhinosinusitis associated with postnasal drip syndrome (PNDS) or gastro-oesophageal reflux disease (GORD) There are many other common causes of chronic cough like Asthma, copd, ild, lung cancer, non resolving pneumonia, Bronchiectasis, pulmonary eosinophila, pl effusion, pneumoconisis, hypersensitive pneumonitis, cardiac involvement etc. But diagnosis is obvious in most cases. IDIOPATHIC COUGH In patients whom none of the usual explanations for cough may be present even after thorough diagnostic work up. Patients with unexplained chronic cough are predominantly female (77%) and are eight times more likely to have an organ-specific autoimmune disease, particularly hypo-thyroidism. Idiopathic cough is associated with air-way inflammation. The levels of several tussive media- tors, including cysteinyl-leukotrienes, histamine, prostaglandin D2 and E2, have been shown to be elevated in induced sputum in these patients Typically the female patients are of peri- or post menopausal age, report a preceding upper respiratory tract infection (URTI) and have a heightened cough reflex to tussive stimuli. TREATMENT Idiopathic cough should be treated with safer cough suppressants like dexromethorphan in higher doses (60 mg per day). It may need to be continued for a longer period. I hope this information will be HELPFUL to your clinical practice.

c/o dry cough on n off wich relieves on medication since 2 yrs.sputum AFB negative.dx n D/Ds

12 yrs male recurrent cough mt negative esr 27 eosinophils 07