Search
upper airway cough syndrome; postnasal drip (UACS)
Etiology:
- associated with chronic rhinitis with or without sinusitis
- allergic rhinitis
- non-allergic rhinitis
Clinical manifestations:
- chronic cough
- seasonal allergies
- clear nasal discharge
- mucoid or mucopurulent sputum
- repeated attempts to clear throat
- discharge may be seen in posterior pharynx
- cobblestoning in posterior pharynx
Differential diagnosis:
- non-asthmatic eosinophilic bronchitis
- cough-variant asthma
Management:
- intranasal glucocorticoids & nasal saline irrigation 1st line
- intranasal ipratropium for rhinorrhea
- antihistamines (loratadine, cetirizine, fexofenadine) for allergic rhinitis
- decongestants (pseudoephedrine) for short-term treatment of non-allergic rhinitis
General
syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19.
American College of Physicians, Philadelphia 2015, 2018, 2021.
- Guide to Physical Examination & History Taking, 6th edition,
Bates B, JB Lippincott, Philadelphia, 1995, pg 72