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The cough reflex is a protective mechanism of the airway; it avoids bronchoaspiration and its complications and, when it is altered, it can appear as a hypersensitivity syndrome; cough per se is the most common symptom for which medical consultation is sought. Chronic cough represents a public health problem with a high degree of morbidity; It represents a syndrome by itself, regardless of the underlying condition. Recent evidence suggests an abnormal and altered neurophysiologic process. Recent literature and new therapeutic mechanisms were reviewed. We are in the process of understanding the cough syndrome. [ABSTRACT FROM AUTHOR]

The nontuberculous mycobacteria are rarely recognized today in the world, being increased their prevalence about to departure of their suspicion in chronic illnesses such as inmunocompromised patients and cystic fibrosis. We present a case with diagnosis of syndrome of Lady Windermere about to departure of a square of chronic cough. Computed tomography was performed where bilateral bronchiectasis is observed in the left lingual segment and right upper lobe. In the Bronchoscopy was isolated complex Mycobacterium avium-intracellulare. The lack of suspicion of nontuberculous mycobacteria in patient without risk factors, with a square of chronic cough leads to the delay in the diagnosis and the patient's clinical deterioration. [ABSTRACT FROM AUTHOR]

Chronic cough is defined as persistent cough for more than eight weeks without a defined diagnosis. Irwin and other authors have identified sinusitis, asthma and gastroesophageal reflux as the most common causes of chronic cough. Objectives: To know the clinical spectrum and the most common causes of chronic cough, as well as lo perform a comparative analysis with the literature. Material and methods: A retrospective and transversal study was performed analyzing the clinical records of patients attending consultation because of chronic cough at Dr. Jose E. Gonzalez University Hospital at the Autonomous University of Nuevo Leon, and the Clínica Cuauhtemoc y Famosa, in Monterrey, Nuevo Leon, Mexico, from January, 1998, to December, 2000. The main symptoms and signs of each patient were analyzed, as well as the final diagnosis of the cough's cause and the response to treatment. In addition, a comparative analysis of the data found. In this population and those reported by Irwin et al on the main cause of this symptom. For the statistical analysis, multivarianza analysis, x2 test and Mantel Haenszel with 2x2 table were used considering a p < 0 05 as significant. Results: One hundred eight records were reviewed, but only 91 were included. The most common final diagnoses were gastroesophageal reflux in 75 patients (82%), followed by sinusitis in 34 cases (37%) and mixed causes (more than two) in 25 subjects (27%) (p = 0 016). All patients responded properly to specific treatment directed to the identified base-disease, with which symptoms were solved. Conclusions: In our population, unlike described by Irwin, the most frequent cause of chronic cough is gastroesophageal reflux, followed by sinusitis and mixed causes. [ABSTRACT FROM AUTHOR]

Cough is the common symptom of patients who seek medical attention; chronic cough being defined as persistent cough longer than three weeks without a definite diagnosis. Cough is a vagal phenomenon which can be initiated in structures with afferences of the vagus or its branches; besides, cough receptors have been described in different parts of the body, mainly tracheobronchial and digestive tract structures, which send afferents to the central nervous system to form the cough reflex. Main causes of chronic cough are retronasal discharge syndrome, gastroesophagic reflux and asthma. The diagnosis of chronic cough requires a careful history and physical examination and paraclinic tests focused on the most frequent causes. Treatment is oriented to identify and correct the disease; anticough medication should be used carefully since cough is a defense mechanism and an alarm sign. [ABSTRACT FROM AUTHOR]