Deep Dry Cough : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 23/07/2022

A deep dry cough is a periodic or persistent cough without sputum production that occurs when the lower respiratory system is irritated. Develop with infectious or non-infectious lesions of the trachea, bronchi, lungs, pleura, pathological processes in the mediastinum. Plain chest x-ray or fluorography, serological methods, tuberculin test, bronchography, bronchoscopy, ultrasound of the mediastinum and pleura are recommended to establish the causes of the symptom. To alleviate the condition before making a diagnosis, humidification of the air, plenty of warm drink, rest with limitation of external stimuli are shown.

Causes of a deep dry cough

Whooping cough

Exhausting bouts of deep convulsive coughing is a characteristic symptom of whooping cough. Paroxysm is provoked by any external stimuli: talking, laughter, pain, touch, etc. The attack consists of 2-15 series of short coughing shocks, continuously following each other. After each series, the child sharply inhales air, which passes with a whistle through the narrowed glottis. After the end of the attack, a small amount of transparent viscous sputum is separated, resembling thick mucus. Sometimes, after a deep cough, reflex vomiting occurs. Whooping cough is called "hundred-day" - it persists for three months, the intensity and frequency of attacks decreases gradually.

With a paroxysm, the child is excited. His face turns red, his eyes are filled with blood, swelling of the neck veins is noticeable. Due to the protrusion of the tongue, a tear or rupture of the frenulum is possible. Muscle tension is accompanied by damage to capillaries, the formation of many small hemorrhages on the sclera and skin of the face. In severe cases, an attack provokes tonic and clonic convulsions, loss of consciousness, respiratory arrest (apnea), involuntary excretion of urine, feces. Moderate catarrhal symptoms, intoxication are noted. Similar manifestations are less pronounced in parapertussis.

Pulmonary tuberculosis

The occurrence of a deep dry cough, which persists for more than three weeks, is accompanied by a temperature of up to 37.5-38 ° C and sweating, which intensifies in the second half of the night, disturbing sleep, is a serious reason for excluding tuberculosis. An unproductive cough is one of the symptoms of focal and infiltrative variants of pulmonary tuberculosis infection, observed in the initial period of acute disseminated pulmonary tuberculosis and without exacerbation in the cirrhotic form of the disease. With tumorous tuberculosis, the symptom is manifested by bitonal attacks.

Tracheitis and bronchitis

Attacks of a deep unproductive cough, which eventually turns into a wet one, combined with soreness, pain behind the sternum or in the chest area, often indicate an inflammatory lesion of the tracheobronchial tree. In an acute process, cough is accompanied by malaise, catarrhal symptoms, fever. Frequent intense coughing attacks provoke an overstrain of the respiratory muscles and abdominal muscles, causing noticeable muscle discomfort.

With laryngotracheitis, hoarseness of the voice and discomfort in the larynx are additionally noted, a reactive increase in the cervical lymph nodes is possible. The spread of inflammation to the bronchi (tracheobronchitis, bronchitis) is evidenced by shortness of breath and wheezing, characteristic of bronchial obstruction. Dry deep cough is quickly replaced by unproductive, and then wet with mucous or mucopurulent sputum. Recurrent or persistent unproductive cough attacks with pain during deep breathing, episodes of hemoptysis are typical of atrophic bronchitis.


Other diseases of the bronchi and trachea

Dry tracheobronchial or bronchial cough can be caused by non-inflammatory causes. In these cases, its occurrence is due to irritation of the receptor apparatus of the bronchi and tracheal bifurcation due to a violation of the draining function or airway obstruction. The symptom is detected in the clinical picture of such diseases as:

  • Williams-Campbell Syndrome . The underdevelopment of cartilaginous tissue contributes to a decrease in tone and dyskinesia of the bronchial wall. Lack of drainage function predisposes to frequent bronchitis, pneumonia. Cough is accompanied by noisy wheezing (stridor) breathing, pronounced shortness of breath, blue nasolabial triangle. Pathology is usually detected in early childhood.
  • Broncho-obstructive syndrome . An organic or functional violation of bronchial patency, in addition to a deep unproductive or unproductive cough, is manifested by noisy breathing with an extended exhalation, asthma attacks. Auxiliary muscles are involved in breathing: the sternocleidomastoid muscles of the neck are tensed, the intercostal spaces are retracted. Children may have sleep apnea.
  • Stenosis of the trachea and bronchi . For congenital and acquired narrowing of the trachea, a cough-fainting syndrome is typical, in which, at the height of an attack of dry barking cough, there is suffocation with dizziness, loss of consciousness, discharge of viscous mucus after an attack. Cough with stenosis of the large bronchi is painful, paroxysmal, combined with stridor breathing with difficult exhalation.
  • Foreign body of the bronchus . In case of accidental ingestion of foreign objects into the respiratory tract, a protective reflex is triggered, triggering a paroxysmal whooping cough. The patient experiences suffocation, the face turns blue, the voice disappears, vomiting and hemoptysis are possible. A similar mechanism for the development of dry cough is typical for bronchial adenoma, however, the symptoms are not so acute, shortness of breath and stridor breathing prevail.

lung disease

An unproductive cough is characteristic of some atypical pneumonias (chlamydial inflammation, respiratory mycoplasmosis, legionellosis), fungal and protozoal processes (candidiasis, cryptococcosis, pneumocystosis), the period of formation of an abscess during a lung abscess. The intensity of a deep cough, the presence and severity of associated symptoms (shortness of breath, suffocation, fever, intoxication) depend on the factor that caused the inflammation. From non-inflammatory pathologies with coughing attacks occur:

  • Diffuse pneumosclerosis . Compaction of the parenchyma due to the growth of connective tissue disrupts normal gas exchange in the lungs. Therefore, in addition to dry cough and thoracic pain in pneumosclerosis, shortness of breath, skin cyanosis, and fatigue are detected.
  • Malignant tumors of the lungs . Cough with hemoptysis and shortness of breath is an early symptom of central lung cancer. With Pancoast's disease, a rough cough occurs against the background of hoarseness, Horner's syndrome, pain in the arm and shoulder, paresthesia in the hand on the side of the lesion, compression of the superior vena cava.
  • Acute atelectasis of the lung . The appearance of a deep cough is preceded by a sharp pain in the affected half of the chest. Increasing shortness of breath, skin cyanosis is revealed. The patient's heart rate increases and blood pressure drops. Typically lagging half of the chest in breathing.
  • Lung injury . Hacking deep cough with weakness, fever, expiratory dyspnea develops with radiation pneumonitis, which complicates radiotherapy of oncopathology. The symptom first worries sporadically during exertion, then constantly and at rest.
  • Antisynthetase syndrome . The main pulmonary manifestations of fibrosing alveolitis in dermatomyositis are a deep cough and shortness of breath. Most patients have a combination of symptoms with fever and Raynaud's phenomenon (pallor and cyanosis of the fingers).
  • Histiocytosis X. A feature of dry cough in people suffering from pulmonary eosinophilic granuloma is its persistent, hoarse character. The patient is also concerned about thoracic pain, shortness of breath. Possible damage to the skin, liver, spleen, lymphadenopathy.

Cough without sputum may precede acute conditions and serve as an initial sign of some lung diseases. The symptom is observed in the prodrome of pulmonary edema, combined with rapid breathing, a feeling of tightness in the chest, dizziness. The periodic appearance of a deep dry cough, shortness of breath on exertion is characteristic of the first stage of pulmonary cystic fibrosis, which can last up to 1 year.

Pleura lesions

Part of the receptors that initiate the cough reflex are located in the pleura. Therefore, pathological processes involving the serous membrane of the lungs, as a rule, proceed with an unproductive cough. The symptom is often combined with chest pain, aggravated during breathing, shortness of breath, cyanotic skin and mucous membranes, fever, intoxication. The appearance of a deep cough without sputum is typical for dry and serous pleurisy, including tuberculous origin. Symptoms also contribute to:

  • Benign tumors of the pleura . The growth of volumetric neoplasms is accompanied by a dry cough, shortness of breath, thoracic pain, subfebrile fever, exudation into the pleural cavity. Possible intercostal neuralgia.
  • Malignant pleural neoplasia . More quickly, such symptoms progress with pleural metastases and pleural cancer. The pains are excruciating, radiating to the shoulder blade, shoulder girdle. Horner's syndrome is detected early, the superior vena cava is compressed.
  • Pneumothorax . Activation of the cough reflex occurs during traumatic excitation of pleural receptors in patients with pneumothorax. In addition to a coughing attack, there is a sharp thoracic pain, shortness of breath, cyanosis or blanching of the face, panic fear of death.

Sometimes the cause of an unproductive deep cough is the reactive excitation of pleural receptors during inflammatory and volumetric processes that occur in the abdominal organs adjacent to the diaphragm. The symptom is described in the clinic of subdiaphragmatic abscess, spleen cysts, although other signs of the listed pathologies are leading in such cases.

Diseases of the esophagus

Excitation of the receptors of the tracheobronchial tree is observed due to their compression in patients suffering from epibronchial diverticula of the esophagus. With large protrusions, night cough is complemented by dysphagia, belching of undigested food and air, nausea, and bad breath. Esophageal cancer is characterized by a combination of progressive dysphagia, dry cough, sensation of pain and a "lump" behind the sternum, and exhaustion due to malnutrition.

Volumetric formations of the mediastinum

Compression of the bronchi, provoking coughing, occurs with lymphoma and other mediastinal tumors, mediastinal cysts, aortic aneurysm. After the stage of the asymptomatic course, such diseases are manifested by thoracic pain of varying intensity, signs of compression of other organs of the chest - attacks of deep coughing, dysphagia, shortness of breath. Headaches and dizziness are possible due to a violation of the venous outflow from the head with the pressure of a volumetric formation on the superior vena cava.

Heart diseases

In dilated cardiomyopathy and coelomic pericardial cysts, the leading cause of dry chest cough is the reaction of compressed bronchi. Diseases occur with the presence of discomfort, pain in the precordial region, palpitations, interruptions, shortness of breath, against which a dry cough periodically appears. In pericarditis and post-infarction syndrome, the reaction of the pleura plays a key role in the implementation of the cough reflex. Coughing appears on the background of shortness of breath, moderate or severe retrosternal or thoracic pain.

Occupational diseases

An unproductive cough manifests itself in a number of occupational diseases that affect the bronchi and lungs - silicosis, silicosis, berylliosis. At the onset of the disease, a dry cough is usually noted, which is gradually replaced by a growing cough and is aggravated by shortness of breath, chest pain, fatigue, and signs of respiratory failure. Occupational pathology develops in patients who inhale dust with silicon dioxide and silicates, beryllium fumes, smoke with its compounds for a long time. In the latter case, a severe acute course with conjunctivitis and hyperthermia is possible.


The causes of a deep paroxysmal cough in allergic lesions of the bronchi and lungs are bronchospasm, swelling and hypersecretion of the mucosa when allergens to which the body is sensitized become ingested. A distinctive feature of the cough episode is the occurrence against the background of suffocation or shortness of breath. Often, at the end of the attack, the patient expectorates a small amount of viscous mucous sputum. The development of a deep allergic cough is noted in such pathological conditions as:

  • Asthmatic bronchitis . Obstruction of the medium and large bronchi due to an allergic reaction of an immediate or delayed type causes bouts of dry cough with noisy labored exhalation and expiratory dyspnea. The disease is provoked by inhalation of dust, fluff, pet hair, plant pollen, in some patients it is a manifestation of food, vaccine, drug allergies or is a consequence of past respiratory infections.
  • Bronchial asthma . Cough of asthmatic origin usually proceeds paroxysmal and is combined with other signs of bronchial obstruction - wheezing heard at a distance, expiratory dyspnea, and occasional suffocation. Dry cough, along with nasal congestion, itchy skin, restlessness, and sleep disturbances, is a harbinger of an attack. The asthmatic suffocation itself is accompanied by an unproductive cough with scanty viscous sputum.
  • Allergic alveolitis . Atopic damage to the alveoli and interstitial lung tissue is characterized by a clinical picture of inflammation. Allergic alveolitis is often preceded by prolonged massive contact with the allergen. The appearance of increasing shortness of breath and dry cough is typical for the acute and subacute course of the disease. The symptom manifests against the background of fever, chills, headaches, general malaise, reminiscent of the symptoms of SARS.
  • Schistosomatid dermatitis . The allergic component is leading in the development of an unproductive deep cough with repeated parasitic skin lesions as a result of the introduction of schistosome larvae living in natural reservoirs. The appearance of coughing attacks with fever and headaches is facilitated by sensitization of the body after a previous invasion. The symptom is observed against the background of typical skin lesions - urticaria, skin itching, red spots and nodules, swelling.


Diagnosis of the causes of a deep dry cough is usually done by a therapist or family doctor. According to indications consultations of profile experts are appointed. The primary examination is aimed at assessing the condition of the lower respiratory tract, with the defeat of which the symptom is most often determined. The primary recommended examination methods are:

  • X-ray studies . Usually, fluorography or a plain chest x-ray is performed as a screening. X-ray diagnostics allows you to detect inflammatory changes, malformations, signs of systemic processes, volumetric formations in the mediastinum, chest.
  • Express diagnostics of tuberculosis . It is prescribed for prolonged unreasonable cough, the presence of information about contacts with patients with tuberculosis infection, the patient's belonging to risk contingents. A tuberculin test or a molecular genetic test is indicated.
  • Serological studies . Due to the absence or meager volume of expectorated sputum, microbiological culture is usually ineffective. Therefore, to exclude a possible infectious process, RIF, ELISA, and PCR diagnostics are more often performed.

A general blood test is performed to detect acute bacterial inflammation, in which the ESR increases, leukocytosis is noted, a shift in the leukocyte formula to the left, as well as allergic processes that occur with eosinophilia. At the next stages of diagnosis, additional pulmonary examination methods are often prescribed (bronchography, bronchoscopy, examination of the function of external respiration, ultrasound of the pleura and mediastinum, tomography of organs located in the chest, etc.), allergy tests.

Chest x-ray is used to detect pathological processes


Symptomatic therapy

The periodic occurrence of attacks of deep dry cough or its persistence for 5-7 days, especially in combination with subfebrile or high fever, other respiratory disorders (shortness of breath, suffocation), thoracic pain is a serious reason for seeking qualified medical help. Self-medication in such cases is unacceptable. The patient is advised to limit physical activity, and in case of fever and poor health, to observe bed rest.

It is important to ensure regular ventilation and sufficient humidification of the air in the room. Before identifying the causes of a deep cough, to alleviate the symptom and relieve intoxication, it is recommended to drink plenty of compotes from dried fruits, fruit drinks from fresh berries, juices, and warm tea. The use of warm alkaline drinks is effective - non-carbonated mineral water, warmed milk with a small amount of soda. If there is a reasonable suspicion of whooping cough, a sick child or adult should be protected from bright light, noise, and other irritants.

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