[Chronic cough in children--what to consider and how to evaluate?].

There is a long list of differential diagnoses for chronic cough lasting longer than 4 weeks in children. Diagnostic work up starts with a detailed history taking and a clinical investigation followed by a chest X-ray (in one plane) and a spirometry. For the latter reliable results can be achieved by children older then 5 years. If the diagnostic work up is still inconclusive and if the child is in good clinical condition, a 4 weeks' course of inhalation therapy with steroids and betamimetics together with a 2 weeks' course of antibiotics with a macrolide is warranted. In case coughing persists a thorough diagnostic work up is indicated to rule out conditions like cystic fibrosis, relevant humoral immuno-deficiencies, primary ciliary dyskinesia, anatomic malformation or chronic pulmonary aspiration, preferably done by a pediatric pulmonologist. Chronic cough has to be considered abnormal in any child under the age of 1 year. For this age group a final diagnosis is of special importance.