Most causes of acute cough do not warrant routine ancillary tests. A chest radiograph may be used in patients with purulent sputum and/or fever, and spirometric analysis may be used to document the presence of airflow obstruction in patients with asthma,
Patients with chronic cough are usually treated based on clinical assessment first, and ancillary tests are performed only if symptoms persist. 1 ,15 Nasolaryngoscopy can be used to document the presence of mucosal inflammation and excessive mucus drainage. Sinus radiographs or computed tomography scanning can document the presence of sinusitis. A chest radiograph can detect focal or diffuse lung disease. Spirometric analysis can identify airflow obstruction, although, in cases of asthma-associated cough, the spirometric values are normal between attacks. GE reflux can be documented by a number of methods; esophageal pH monitoring is probably the most useful.
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