Cough in the immunocompromised host: ACCP evidence-based clinical practice guidelines

Abstract

Background: Patients with compromised immune systems often complain of chronic cough. While these patients are susceptible to opportunistic infections that should be considered in the evaluation, common causes should also be investigated.

Methods: MEDLINE search using the terms "cough," "immunocompromise," "HIV," "AIDS," "neutropenia," and "corticosteroids," from 1966 through the end of 2003.

Results: Patients with compromised immune systems and chronic cough usually have the same disorders causing cough as in the general population. However, depending on the nature and severity of the immune defect, they may also have a variety of infections not usually encountered in immunocompetent hosts.

Conclusion: In immunocompromised patients presenting with cough, the initial diagnostic evaluation should be the same as that for healthy hosts. However, when these diagnoses have been excluded, opportunistic infections should be considered.