Approach to a cough (pediatrics) Quiz: Ace Your Exams

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A 6-year-old boy is brought to the clinic due to a persistent cough for the past two weeks. The cough is dry, occurs intermittently throughout the day, and worsens at night. There is no history of fever, recent illness, weight loss, or exposure to sick contacts. Immunizations are up-to-date. Temperature is 37°C (98.6°F), heart rate is 95/min, respiratory rate is 22/min, blood pressure is 100/65 mmHg, and oxygen saturation is 98% on room air. The nasal turbinates are pale and boggy with clear rhinorrhea, and dark infraorbital discoloration is noted. Lung auscultation reveals normal bilateral breath sounds without wheezing or crackles. Which of the following is most likely to be present on further history-taking?

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Symptoms triggered by exposure to pollen

Exercise intolerance with polyphonic wheezing

History of recurrent episodes of pneumonia

Spontaneous forceful coughing episodes with post-tussive vomiting

Choking or coughing episodes during meals