Differential Diagnosis for Morning Cough in a 5-Year-Old
Single Most Likely Diagnosis
- Asthma: This is a common condition in children that can cause coughing, especially in the morning. Asthma symptoms can be triggered by various factors, including allergens, respiratory infections, and environmental factors. The morning cough could be due to the accumulation of secretions overnight or exposure to allergens like dust mites in bedding.
Other Likely Diagnoses
- Upper Respiratory Tract Infection (URTI): Viral infections are common in children and can cause cough, which may be more pronounced in the morning due to the accumulation of secretions overnight.
- Allergic Rhinitis: Allergies to dust mites, pet dander, or pollen can cause chronic cough, especially in the morning after exposure to these allergens overnight.
- Reactive Airway Disease: Similar to asthma, this condition involves airway hyperreactivity and can cause cough, wheezing, and shortness of breath, often triggered by respiratory infections or environmental factors.
Do Not Miss Diagnoses
- Pertussis (Whooping Cough): Although less common due to vaccination, pertussis can still occur, especially in areas with low vaccination rates. It's characterized by a severe, persistent cough that may be accompanied by a whoop sound.
- Foreign Body Aspiration: This is an emergency that requires immediate attention. A child may cough persistently if a foreign object is lodged in the airway.
- Cystic Fibrosis: A genetic disorder that leads to the production of thick, sticky mucus, causing chronic respiratory infections and cough.
Rare Diagnoses
- Habit Cough: A psychogenic cough that can occur in the absence of any underlying respiratory disease. It's often seen in school-aged children and can be challenging to diagnose.
- Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can irritate the airways and cause coughing, which may be worse in the morning.
- Primary Ciliary Dyskinesia: A rare genetic disorder affecting the cilia in the respiratory tract, leading to chronic respiratory infections and cough.
- Tuberculosis: Although rare in many parts of the world, TB can cause chronic cough and must be considered, especially if the child has been exposed to someone with TB or has recently traveled to an area with high TB prevalence.