Persistent Dry Cough Without Sputum

CLINICAL DIAGNOSTIC MANUAL

Persistent dry cough without sputum is a common symptom in various respiratory and non-respiratory conditions. Unlike productive cough, this type of cough does not produce mucus and can be irritating and exhausting for the patient.

It may be caused by environmental irritants, infections, chronic diseases, or even medications. Identifying the underlying cause is crucial for appropriate treatment, as dry cough can significantly impact the patient’s quality of life.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Smokers	Persistent dry cough, throat irritation, mild dyspnoea	History of smoking, physical examination	Chest X-ray, spirometry
Chronic asthma	Dry cough, wheezing, dyspnoea, chest tightness	Clinical history, physical examination, pulmonary function tests	Spirometry, bronchodilator test
Gastroesophageal reflux disease (GERD)	Dry cough, heartburn, acid regurgitation, epigastric pain	Clinical history, physical examination	Esophageal pH monitoring, endoscopy
Postnasal drip	Dry cough, sensation of dripping at the back of the throat, nasal congestion	Clinical history, physical examination	Sinus examination, nasopharyngoscopy
Post-viral infection recovery	Persistent dry cough following symptoms of a viral infection (fever, malaise)	Clinical history, physical examination	Clinical diagnosis
ACE inhibitors	Persistent dry cough, onset after starting the medication	Clinical history, medication review	Discontinuation of the medication, clinical reassessment
COPD (Chronic Obstructive Pulmonary Disease)	Dry cough, dyspnoea, wheezing, history of smoking	Clinical history, physical examination, chest X-ray	Spirometry, bronchodilator test
Lung carcinoma	Persistent dry cough, weight loss, dyspnoea, chest pain	Clinical history, chest X-ray, computed tomography (CT)	Lung biopsy, bronchoscopy, sputum cytology
Pulmonary tuberculosis	Persistent dry cough, fever, night sweats, weight loss	Clinical history, chest X-ray	Sputum culture, tuberculin test, PCR for Mycobacterium tuberculosis
Interstitial lung disease	Persistent dry cough, progressive dyspnoea, fatigue	Clinical history, physical examination, chest X-ray	High-resolution CT (HRCT), lung biopsy
Others	Varies depending on the specific pathology but may include dyspnoea, fatigue, systemic symptoms	Clinical history, physical examination, imaging and lab tests as indicated	Specific tests such as biopsies, cultures, pulmonary function tests, etc.