Q: My 11-year-old has a tickly, phlegmy cough for 2 months, worse at night. What could it be?

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Question:

My 11-year-old daughter developed a tickly, phlegmy cough almost two months ago, right after recovering from sinusitis. The cough improves with medication but comes back as soon as we stop. It seems to be worse in the evenings. An allergy blood test came back positive for various allergens, including certain pollens and foods. Our local doctor ruled out whooping cough, but we're stuck in a cycle and aren't sure what to do next. What kind of tests should we consider, and which specialist should we see?

Answer:

A chronic cough lasting nearly two months in your 11-year-old daughter must be very concerning, especially with the frustrating pattern of recurrence after stopping medication.

Based on the current symptom pattern:

• A tickly, phlegmy cough that began after sinusitis

• Worsening symptoms in the evening

• Responds to medication but relapses upon discontinuation

• Positive allergy test results (e.g., willow, egg yolk)

Here are some possibilities we should consider:

1. Postnasal Drip Syndrome: This is common after sinusitis, where mucus drips down the back of the throat, causing irritation.

2. Cough-Variant Asthma: Characterized by a tickly cough that often worsens at night or in the early morning.

3. Allergic Cough: A reaction to exposure to specific allergens.

Recommended Tests and Consultations:

→ See a Pediatric Pulmonologist or Allergist.

• Pulmonary Function Test (PFT): To help rule out asthma.

• Methacholine Challenge Test: To check for airway hyperresponsiveness.

• Sinus X-ray or CT Scan: To confirm if postnasal drip is the cause.

• Specific IgE Antibody Test: For a more detailed allergy profile.

Things you can do immediately:

• Use a humidifier in her room at night.

• Adjust her pillow to slightly elevate her head.

• Avoid known allergens (e.g., limit egg intake).

• Keep a cough diary to track patterns.

I recommend scheduling an appointment with a pediatric pulmonology department at a university or larger hospital. Identifying the exact cause is crucial for managing a chronic cough effectively.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us