Differential Diagnosis for Night Cough in Children
Single Most Likely Diagnosis
- Asthma: This is often the most common cause of a night cough in children, especially if it's associated with wheezing, shortness of breath, or a history of allergies. Asthma can cause airway inflammation and constriction, leading to coughing, particularly at night when the airways tend to constrict more.
Other Likely Diagnoses
- Upper Respiratory Tract Infection (URTI): Common colds and other viral infections can cause a night cough due to postnasal drip irritating the throat.
- Allergic Rhinitis: Similar to URTI, allergies can lead to postnasal drip, causing a cough, especially at night when lying down.
- Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can irritate the throat, leading to a cough, which may worsen at night due to lying down.
- Bronchitis: Either acute or chronic bronchitis can cause a persistent cough, including at night, due to inflammation of the bronchial tubes.
Do Not Miss Diagnoses
- Pneumonia: Although less common, pneumonia is a serious condition that requires prompt treatment. A night cough can be a symptom, especially if accompanied by fever, difficulty breathing, or chest pain.
- Foreign Body Aspiration: In younger children, aspiration of a foreign body can cause a sudden onset of coughing, which may be more pronounced at night due to increased respiratory rate during sleep.
- Tuberculosis (TB): Although rare in many areas, TB is a critical diagnosis not to miss, as it requires specific treatment. A chronic cough, including at night, can be a symptom.
- Cystic Fibrosis: This genetic disorder leads to persistent lung infections and can cause a chronic cough, among other symptoms. Early diagnosis is crucial for management.
Rare Diagnoses
- Habit Cough: A psychogenic cough that can occur at any time, including at night, often without any underlying pulmonary cause.
- Bronchiectasis: A condition characterized by damaged, widened airways, leading to chronic cough and infections.
- Primary Ciliary Dyskinesia (Kartagener Syndrome): A rare genetic disorder affecting the cilia, leading to chronic respiratory infections and cough.
- Congenital Heart Disease: Certain heart defects can lead to increased pulmonary blood flow or pressure, causing a cough, which may be worse at night.