2047 Chronic cough without wheezing in young children as a manifestation of chronic sinusitis

Thursday, 15 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Charles Song, MD , Pediatrics, Harbor-UCLA, Torrance, CA

Andrew Wong , Internal Medicine, La County-USC Medical Center

Background: Chronic cough without wheezing in young children often presents diagnostic challenge.

Objective: To investigate the usefulness of nasal endoscopy in differentiating bacterial sinusitis from viral upper respiratory infection, cough variant asthma, allergic rhinitis, and GERD.  

Method:We have retrospectively analyzed data from 14 young children under the age of 5 who presented in our clinic with chronic cough without wheezing. Nine children were evaluated with nasal endoscopy.

Results:All of 9 (100%) children evaluated with nasal endoscopy had thick purulent discharge in the nasopharynx and five (56%) of them had adenoid enlargement for the age.  Ten of 13 (77%) children given antibiotic treatment reported symptom resolution in their two week follow-up appointment.

Conclusion:Using nasal endoscopy, we found that the majority of children with chronic cough without wheezing had chronic bacterial sinusitis and had a striking response to an appropriate antibiotic therapy. Adenoid hypertrophy may be the cause or, more likely, the result of chronic upper airway infection.