Hiroshi Mukae: Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Takeshi Kaneko: Department of Pulmonology, Yokohama City University Graduate School of Medicine, Japan.
Yasushi Obase: Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan. Electronic address: obaseya@nagasaki-u.ac.jp.
Masaharu Shinkai: Division of Respiratory Medicine, Department of Internal Medicine, Tokyo Shinagawa Hospital, Japan.
Toshio Katsunuma: Department of Pediatrics, Daisan Hospital, The Jikei University School of Medicine, Japan.
Kiyoshi Takeyama: Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Japan.
Jiro Terada: Department of Respirology, Graduate School of Medicine, Chiba University, Japan.
Akio Niimi: Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan.
Hiroto Matsuse: Division of Respiratory Medicine, Department of Internal Medicine, Toho University Ohashi Medical Center, Japan.
Kazuhiro Yatera: Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
Yoshihiro Yamamoto: Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Japan.
Arata Azuma: Department of Pulmonary Medicine, Infection and Oncology, Nippon Medical School, Japan.
Hirokazu Arakawa: Kitakanto Allergy Institute Care and Education Centre KIBOU, Japan.
Takashi Iwanaga: Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Japan.
Haruhiko Ogawa: Department of Environmental and Preventive Medicine, Kanazawa University, Japan.
Kiyoyasu Kurahashi: Department of Anesthesiology and Intensive Care Medicine, International University of Health and Welfare School of Medicine, Japan.
Yasuhiro Gon: Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Japan.
Hirokazu Sakamoto: Department of Otolaryngology, Head and Neck Surgery Osaka city university Graduate school of medicine, Japan.
Yoko Shibata: Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Japan.
Tsutomu Tamada: Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan.
Yasuhiko Nishioka: Department of Respiratory Medicine & Rheumatology, Graduate School of Biomedical Sciences Tokushima University, Japan.
Shusaku Haranaga: University Hospital, University of the Ryukyus, Comprehensive Health Professions Education Center, Japan.
Shigeharu Fujieda: Division of Otorhinolaryngology-Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Japan.
Naoyuki Miyashita: First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
Hiroyuki Mochizuki: Department of Pediatrics, Tokai University School of Medicine, Japan.
Akihito Yokoyama: Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Japan.
Shigemi Yoshihara: Department of Pediatrics, Dokkyo Medical University, Japan.
Jun Tamaoki: Tokyo Women's Medical University, Japan.
Cough and sputum are common complaints at outpatient visits. In this digest version, we provide a general overview of these two symptoms and discuss the management of acute (up to three weeks) and prolonged/chronic cough (longer than three weeks). Flowcharts are provided, along with a step-by-step explanation of their diagnosis and management. Most cases of acute cough are due to an infection. In chronic respiratory illness, a cough could be a symptom of a respiratory infection such as pulmonary tuberculosis, malignancy such as a pulmonary tumor, asthma, chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis, drug-induced lung injury, heart failure, nasal sinus disease, sinobronchial syndrome, eosinophilic sinusitis, cough variant asthma (CVA), atopic cough, chronic laryngeal allergy, gastroesophageal reflux (GER), and post-infectious cough. Antibiotics should not be prescribed for over-peak cough but can be considered for atypical infections. The exploration of a single/major cause is recommended for persistent/chronic cough. When sputum is present, a sputum smear/culture (general bacteria, mycobacteria), cytology, cell differentiation, chest computed tomography (CT), and sinus X-ray or CT should be performed. There are two types of rhinosinusitis. Conventional sinusitis and eosinophilic rhinosinusitis present primarily with neutrophilic inflammation and eosinophilic inflammation, respectively. The most common causes of dry cough include CVA, atopic cough/laryngeal allergy (chronic), GER, and post-infectious cough. In the last chapter, future challenges and perspectives are discussed. We hope that the clarification of the pathology of cough hypersensitivity syndrome will lead to further development of "pathology-specific non-specific therapeutic drugs" and provide benefits to patients with chronic refractory cough.
