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Is my daughter's chronic cough due to tuberculosis?

Dr PSN Menon
Consultant & Head, Department of Pediatrics
Jaber Al-Ahmed Armed Forces Hospital, Kuwait

Q: My daughter is 2 years and 8 months old. We had been to a hill station where she suffered from shortness of breath, cold and some cough. After rest for a couple of days she recovered. But now after 45 days, she is suffering from cold and cough every night. She coughs intermittently with heavy cold at night. She was given Tixylix paediatric syrup to relieve cough. My wife has a habit of shutting all doors and windows while sleeping at night to avoid the cold breeze. On top of that she has the mosquito repellant liquid on, all night in the closed room. My daughter has stopped having chocolates, ice creams etc. on her own fearing that they will cause cough. I am afraid she has contracted tuberculosis (TB). I suffer from asthma in the pre winter season. Please advise.

A:There are a number of reasons why your daughter is coughing every night. Tuberculosis could be one of the causes, but it is usually associated with low grade fever, lethargy, failure to gain weight or loss of weight. It should be considered if there is an exposure to an adult with tuberculosis. The diagnosis is usually made with the aid of Mantoux (tuberculin) test, X-ray of chest and blood tests and culture of tubercle bacilli from sputum or stomach washings. Chronic cough could be the most prominent symptom of asthma and there may be no wheeze. I think it is a strong possibility with the family history of asthma. It can be due to passive smoking, dampness with associated mould on the walls, air pollution and exhaust fumes. Thus sleeping in a closed room with poor ventilation and use of burning mosquito repellants could be a cause for the nocturnal cough. Rarely, it could be due to a disease of the lungs or bronchi such as cystic fibrosis. More commonly it could be because of post-nasal discharge (dripping of mucus and secretions from the back of nose) or adenoids. A thorough examination by a paediatrician can rule out most of these conditions.