Etiologies of chronic cough in children: a two-year experience from a tertiary pediatric pulmonology center

Background/aim: Chronic cough is a common yet diagnostically challenging symptom in pediatric pulmonology. This study aimed to evaluate the etiologies of chronic cough in children referred to a tertiary center and to analyze the relationship between specific cough characteristics and final diagnoses. Materials and methods: This retrospective study evaluated patients presenting with chronic cough (duration >4 weeks) at a tertiary pediatric pulmonology center. Demographic data, cough characteristics (wet vs. dry), and diagnostic findings were analyzed. Results: A total of 62 patients were included. A specific etiology was identified in 95.1% of the patients. Asthma and reactive airway disease were the most common diagnoses (45.2%), predominantly associated with dry cough. Notably, we observed an unexpectedly high prevalence of primary ciliary dyskinesia (PCD) (19.4%) and cystic fibrosis (CF) (6.5%), particularly in the wet cough group. This distribution differs significantly from primary care studies, reflecting the selected, refractory nature of patients referred to our tertiary center. Protracted bacterial bronchitis (PBB) was identified in only 3.2% of cases. Conclusion: While asthma remains the leading cause of dry cough, structural lung diseases such as PCD and CF are major etiologies in children presenting with chronic wet cough in tertiary settings. The high rate of these serious conditions underscores the need for early and detailed investigation in patients unresponsive to standard therapies, rather than repeated empirical treatments for presumed PBB.