It is common for physicians to inquire from patients about shortness of breath or nighttime coughing spells.  Concerns should be raised about the possibilities of lower respiratory involvement versus upper respiratory involvement when there is intense cough, cough associated with exercise, or when the cough makes the individual awake at night.  In children, we usually consider cough to be acute, usually mild, not constant, and not involving shortness of breath.  If the cough is lingering or involves shortness of breath or is not improving, seek a healthcare professional.

Typical symptoms on an upper respiratory infection or “cold” are common in all age groups, these include runny nose, runny eyes, sneezing, fevers, and sore throats; however, you need to consider other causes, in addition to infections, particularly when the symptoms are lingering or involve shortness of breath. In all age groups, your doctor should include a comprehensive history to look for evidence of allergies, smoking history, cardiac history, or reflux history which could contribute to cough.  If the cough is moderate, constant, includes shortness of breath, or has a nighttime presentation, see a doctor.  Other non-infectious causes of cough may include congenital anomalies, foreign bodies, asthma, copd, reflux, or allergies. Historical information and specific cough details may help your doctor to determine what therapies are warranted.

It is important to remember that all coughing episodes do not support the need for an antibiotic at the doctors visit.  For example, asthma sufferers may need acute treatment with oral steroids to control the inflammation associated with asthma, for reflux sufferers the acute therapy may be antacid therapy and for common cold sufferers, the treatment may include frequent nasal saline and fever control to help promote healing  and resolution of the nagging symptoms of a cold.  But the simple message here is, not all colds are colds and to know when to seek medical attention.