Don’t Dismiss Postinfectious Cough

In adults who present with persistent cough following an upper respiratory tract infection but who have no history of asthma or chronic obstructive pulmonary disease, lung findings are usually "normal" on auscultation. I ask such patients to perform a forced expiratory maneuver, which often elicits audible wheezing or rhonchi (sometimes it simply triggers cough). The patients frequently admit that they have been afraid to take deep breaths or laugh for fear of provoking cough. These responses help identify hyperreactive airways, which I treat with inhaled β₂-agonists and either inhaled corticosteroids or a short course of oral corticosteroids.