Cases reported "Cough"

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1/52. Tourette's syndrome mimicking asthma.

    Tourette's syndrome is a neurological disorder consisting of chronic motor tics and involuntary vocalizations. Some of these vocalizations include coughing, grunting, and wheezing. We report two adolescents with a history of chronic coughing who presented for further evaluation of previously diagnosed asthma. A careful history suggested that Tourette's syndrome might be responsible for the patients' symptoms. neurology evaluation confirmed the correct diagnosis of Tourette's syndrome for both patients. Treatment specific for this disease led to ablation of all symptoms. A history of repetitive coughing in adolescents may be the presenting symptom of Tourette's syndrome, thereby mimicking cough-equivalent asthma.
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2/52. Persistent cough in an adolescent.

    Jessica, a 14-year-old girl with a history of asthma, went to her pediatrician's office because of a persistent cough. She had been coughing for at least 3 months with occasional cough-free periods of less than a few days. The cough was nonproductive and was not accompanied by fever, rhinorrhea, or facial or chest pain. Jessica and her mother observed that the cough increased with exercise and typically was not present during sleep. She has used two metered-dose inhalers--albuterol and cromolyn--without any change in the cough pattern. For the past 5 years, Jessica has had mild asthma responsive to albuterol. She enjoys running on the cross-country team, soccer, and dancing. She is an average student and denies any change in academic performance. She has never been hospitalized or had an emergency department visit for asthma or pneumonia. There has been no recent travel or exposure to a person with a chronic productive cough, tobacco smoke, or a live-in pet. Jessica lives with her mother and younger sister in a 10-year-old, carpeted apartment without any evidence of mold or recent renovation. In the process of taking the history, the pediatrician noticed that Jessica coughed intermittently, with two or three coughs during each episode. At times, the cough was harsh; at other times, it was a quiet cough, as if she were clearing her throat. She was cooperative, without overt anxiety or respiratory distress. After a complete physical examination with normal findings, the pediatrician interviewed Jessica and her mother alone. Jessica's parents had been divorced for the past 6 years. She lived with her mother but visited her father, and his new family with two young children, every weekend. She spoke about this arrangement comfortably and said that she loved her father and mother but didn't like the tension she experienced at her father's home. "I don't like adults arguing when kids are around." When asked why she thought the cough persisted so long, she commented in a neutral tone, "I don't know. It's never been like this before." Jessica's pediatrician prescribed an inhaled steroid with the albuterol. When the cough did not respond after 1 week, he ordered a chest radiograph (normal) and a tuberculin skin test (purified protein derivative-negative), and he added montelukast (a leukotriene inhibitor) and monitored airway resistance with a peak flow meter. The cough persisted, and the peak flow recording showed normal airway resistance. At this time, Jessica's pediatrician suspected a conversion reaction and contemplated the next best therapeutic strategy.
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keywords = asthma
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3/52. Tracheal lipoma: a rare intrathoracic neoplasm.

    Primary tracheal lipomas are extremely rare neoplasms. The typical patient is a middle-aged man with complaints of cough and shortness of breath. Often, the diagnosis is delayed, and patients are treated for asthma or bronchitis. The diagnosis of a tracheal lipoma is best approached by computed tomography (CT) and bronchofibroscopy. Tracheobronchial lipomas may be successfully excised endoscopically or by laser therapy. Open surgical resection is required when the lipoma extends extraluminally.
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ranking = 0.16666666666667
keywords = asthma
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4/52. Massive left diaphragmatic separation and rupture due to coughing during an asthma exacerbation.

    We report a case of herniation of abdominal contents into the left hemithorax in a patient hospitalized with an acute exacerbation of asthma accompanied by paroxysms of coughing. There was no history of trauma. We believe this is the first reported case of diaphragmatic rupture complicating an asthma exacerbation. We review clinical features, pathophysiology, diagnosis, and treatment of diaphragmatic rupture in its most common setting, trauma, and discuss its occasional "spontaneous" occurrence.
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keywords = asthma
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5/52. Chronic eosinophilic pneumonia: a case report.

    Chronic eosinophilic pneumonia (CEP) is a disorder, characterized by a history of pneumonia (> 2 months) and eosinophilic pulmonary infiltration without any organic causes. We describe a 28-year-old woman who presented with cough, dyspnea and fever for 2 months. She was diagnosed with mild asthma and allergic rhinitis 2 years before being diagnosed with CEP. For a period of 9 months she took no medication. Her chest roentgenogram at this admission revealed patchy infiltration in both upper lung fields. Laboratory data revealed blood eosinophilia (4,284/mm3), and her serum IgE was mildly elevated (245.8 IU/ml). A computerized tomography of the chest did not show bronchiectasis. CEP was diagnosed from significant eosinophilia in bronchoalveolar larvage fluid and transbronchial biopsy revealed eosinophilic infiltration without any demonstrable infectious agent. The patient was treated with prednisolone 45 mg/day. Her symptoms disappeared and her chest roentgenogram showed nearly complete resolution in 2 and 4 days, consecutively.
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ranking = 0.16666666666667
keywords = asthma
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6/52. A teenager with an annoying cough.

    Chronic cough is a stressful condition and can lead to extensive investigations. Bronchial asthma and postnasal drip syndrome are common causes, but sometimes the origin of cough is outside the respiratory tract (1,2). Such a relatively simple test as esophageal pH probing may suggest appropriate (antireflux) therapy.
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ranking = 0.16666666666667
keywords = asthma
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7/52. Respiratory diseases with a psychosomatic component in adolescents.

    Adolescence is often a time of emotional upheaval and it is no wonder that many respiratory diseases with a psychosomatic component find their origins or time of exacerbation during this time of life. Adolescents who present with unexplained respiratory diseases may also suffer from some form of psychosomatic illness. Recognition of the psychological contributions to symptoms related to the respiratory tract is essential for practitioners who care for adolescents. This article includes some of the more common respiratory or related conditions that have psychological etiologies or components and are encountered in the adolescent patient. These include psychogenic cough, sighing dyspnea, hyperventilation, vocal cord dysfunction, and emotional state as a trigger for asthma. This review provides a general discussion of these conditions and an overview of issues related to psychological/psychiatric evaluation and the reluctance of patients and their parents to access mental health treatment.
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ranking = 0.16666666666667
keywords = asthma
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8/52. mucus plugging as a cause of acute lobar overdistension.

    Acute lobar overdistension in children is usually indicative of foreign body aspiration, especially when a history of a choking episode is recalled. An unusual presentation of asthma as recurrent overdistension of the left lung in a toddler is described. The child had undergone two consecutive negative bronchoscopies with a presumptive diagnosis of foreign body aspiration; however, it was only the antiasthmatic treatment that resulted in an excellent outcome.
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keywords = asthma
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9/52. lidocaine inhalation for cough suppression.

    The purpose of this study was to observe the effectiveness of lidocaine in suppressing cough which is a logical extension of its established use in bronchoscopy. Nebulized lidocaine, preceded by standard nebulized albuterol inhalation driven by oxygen was given to suppress cough in a selected group of patients with intractable cough severe enough to disrupt daily life activities, especially sleep. patients included those with asthma, reactive airways disease, and chronic obstructive pulmonary disease (COPD). In these selected patients, nebulized lidocaine was very effective in suppressing cough, and thus buying time for more definitive therapies to work. This observation merits further study and confirmation for the benefit of patients.(Am J Emerg Med 2001;19:206-207.
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ranking = 0.16666666666667
keywords = asthma
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10/52. Psychogenic cough in adults: a report of two cases and review of the literature.

    Psychogenic cough, also known as "habit cough," is a well-documented condition in the pediatric and adolescent population, with numerous cases reported in the medical literature. Many of these patients are strikingly similar in their clinical characteristics and, although the data are limited, a variety of treatment options may be successful in terminating this form of cough. However, psychogenic cough in adults has been reported infrequently and is less well defined. We report two cases of psychogenic cough in adult patients referred to our service for an evaluation of refractory, chronic cough and review the relevant medical literature. Our patients seemingly represent the first cases of psychogenic cough reported in the geriatric population and share clinical features with children, adolescents, and young adults. One case is unique in the sense that the cough responded to a distracter in the form of a throat lozenge, and this patient consumed > or = 20 lozenges/day for approximately 13 years. Psychogenic cough should be considered in adult patients who present with a chronic cough of no obvious organic basis that has failed therapy directed at postnasal drip, asthma, and gastroesophageal reflux. We propose criteria to assist in making a diagnosis of psychogenic cough in adult patients and review the limited information that exists concerning treatment modalities.
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ranking = 0.16666666666667
keywords = asthma
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