Dry Cough Case Study

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Thank you very much for referring Simone along for further investigation of her now nine to ten-month history of dry cough. As you are aware she believes this started with an upper respiratory tract infection in about October of last year. Since that time she has had a dry cough which persists throughout the day but it is not disturbing her sleep. It has not been productive of any sputum. It is not associated with any shortness of breath or wheeze nor any significant chest tightness. She has no nasal symptoms, no symptoms of GORD and has not been associated with any change in her home or university environment. As you are aware six months ago she moved up to Sydney to study her Masters of Physiotherapy and returns here for holidays, but of note the cough is the same in both environments. Thank you for organising a chest x-ray that was…show more content…
She has noticed no significant voice changes and no other symptoms suggestive of underlying tissue disorder. On examination, she was well looking. The cough today was present throughout the consultation and was a mixture of throat clearing and a dry laryngeal cough. Peripherally there was no clubbing, she was saturating at 99% on room air and her lung fields were clear. Examination of her oropharynx revealed moderate degree tonsillar enlargement, but these were not reddened and she believes they are longstanding. Impression/Management: The laryngeal nature of her cough does make me wonder about the contribution of laryngeal hypersensitivity to her cough. Given the 10% incidence of asymptomatic GORD contributing to this, I have started her on a six-week trial of Nexium 20mg twice a day. Alongside this I have counselled her on some strategies to try and decrease irritation of the back of the larynx including forceless follows and sipping on cold

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