Superficial Cough : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 06/09/2022

A superficial cough (cough) is a cough paroxysm without sputum separation or discharge of a small amount of mucus when the upper respiratory tract is affected. It may have natural causes or indicate diseases of the oropharynx and larynx, allergies, complications when taking medications. To establish the causes of the symptom, an instrumental examination of the respiratory organs, esophagoscopy, contrast radiography of the esophagus, ultrasound of the thyroid gland, serological and microbiological methods, and allergy tests are recommended. To alleviate the condition before making a diagnosis, it is permissible to use antiseptics, local anesthetics, inhalations.

Causes of a superficial cough

The development of cough is associated with direct and indirect irritation of numerous receptors located in the upper respiratory tract. Natural factors that provoke a cough attack are choking, inhalation of strong-smelling or active substances. Sometimes excitement becomes a prerequisite for coughing. Pathological causes of cough are diseases in which the receptors of the mucous membrane of the respiratory organs are activated due to damage by infectious agents, aggressive gases and foreign bodies.

Acute viral infections

A dry, unproductive cough is manifested by infectious diseases caused by viruses that, when invaded, invade the respiratory mucosa, irritating its receptors. Depending on the pathogen, the main inflammatory process is localized in different parts of the respiratory tract, which determines the specificity of the infection. With the onset of a superficial cough, the classic flu and its serovariants (Hong Kong, swine), parainfluenza, and other acute respiratory viral infections occur.

The disease begins acutely. The appearance of a cough, redness and sore throat, runny nose, and other catarrhal phenomena may be preceded by a short period of intoxication with fever, pain in the muscles, joints, headaches, and sometimes vomiting. When infected with adenoviruses, conjunctivitis and lymphadenopathy develop. Persistent unproductive cough is typical for respiratory syncytial infection, especially with subsequent penetration of the pathogen into the trachea and bronchi.

Children's infections

Attacks of superficial cough are observed when infected with parapertussis bacteria. Coughing, and then cough paroxysms occur with measles, rubella. With the introduction of pathogens into the respiratory mucosa and the multiplication of viral particles in the mucous layer, receptors are irritated that stimulate the cough reflex, and catarrhal manifestations develop. The spread of viruses through the systemic circulation is accompanied by an increase in lymph nodes, a characteristic exenthematous rash, moderate or severe intoxication.

Diseases of the nasopharynx

The reflex occurrence of a constant superficial cough is provoked by stimulation of the receptors of the posterior pharyngeal wall and palatine tonsils. Irritating factors are mediators released during infectious and inflammatory processes, a secret flowing from the nasal cavity, and foci of tissue destruction. The causes of superficial cough are:

  • Inflammation of the tonsils . Chronic tonsillitis during remission is characterized by obsessive coughing with moderate soreness in the throat, and an unpleasant odor from the oral cavity. Possible subfebrile temperature, asthenia. During a strong cough, whitish dense masses with a putrid odor stand out from the affected amygdala lacunae.
  • Bacterial pharyngitis and nasopharyngitis . Up to 20% of nasopharyngeal inflammation is caused by bacteria. Cough in acute and chronic rhinopharyngitis, pharyngitis is combined with dryness, perspiration, pain in the throat, nasal congestion. It is extremely difficult, with intoxication, hyperthermia and vomiting, nasopharyngitis occurs with meningococcal infection.
  • Postnasal drip syndrome . For obsessive superficial cough caused by irritation of the larynx and pharynx with discharge from the nose or paranasal sinuses, aggravation at night and after awakening is pathognomonic. Patients complain of a burning sensation and dryness in the back of the nose, a "lump" in the region of the posterior pharyngeal wall. The voice often changes.
  • Hypopharyngeal Zenker diverticulum . At the initial stages, there is a rare cough, copious saliva, sore throat, bad breath, difficulty swallowing. Subsequently, dysphagia intensifies, there is an eructation of food eaten, kakosmiya, a feeling of a coma in the throat. A palpable asymmetric formation appears on the neck.



Factors provoking an unproductive paroxysmal cough with allergies are non-microbial and microbial antigens that enter the body from outside or are already present in it. Often, with an allergic reaction from the respiratory system, persistent itching without a rash, lacrimation, and redness of the eyes are also detected. Allergy to dust and other inhaled allergens is manifested by the clinic of such diseases as:

  • allergic rhinitis . Cough develops against the background of bouts of repeated sneezing, nasal congestion, severe watery rhinorrhea. Manifestations are more noticeable in the morning and upon contact with a likely allergen.
  • Allergic laryngitis . Typically, the occurrence of a dry barking cough against the background of rapid swelling of the mucous membrane of the larynx after contact with the allergen. The patient experiences a lack of air, the nasolabial triangle turns blue. In severe cases, respiratory arrest occurs.


The main features of a superficial dry or unproductive cough with inflammation of the larynx are a barking character, voice changes (hoarseness, hoarseness, weakening up to aphonia - complete disappearance). Often worried about the feeling of dryness, burning, foreign matter in the throat. All types of inflammatory lesions of the larynx occur with coughing attacks:

  • Acute laryngitis . The leading signs are hoarseness, weakening or disappearance of the voice against the background of a barking superficial cough. Perhaps low-grade fever, mild or moderate intoxication with general malaise. In young children, the disease sometimes manifests itself as a false croup, in which the clinic is aggravated by inspiratory dyspnea with noisy wheezing, blanching of the skin, and the risk of respiratory arrest.
  • Chronic laryngitis . The catarrhal form of the disease is characterized by a combination of discomfort in the throat, coughing with rapid voice fatigue, paresthesia. Outside of exacerbation, coughing attacks are replaced by constant coughing. Special signs of chronic atrophic laryngitis are the intensification of manifestations when inhaling cold air, the feeling of a lump of mucus in the throat, which the patient tries unsuccessfully to cough up.

Foreign bodies of the pharynx and larynx

In case of accidental ingestion of food or a foreign object into the upper respiratory tract, the cough often becomes convulsive, debilitating, accompanied by a blue face. Breathing and swallowing are difficult. The secretion of saliva is markedly increased. The patient experiences a sore throat that may radiate to the ear. Painful sensations are especially intense when a sharp object hits or gets stuck in the tonsils. Reflex vomiting is possible, and when filling the larynx with soft elastic food - asphyxia. Cough persists for some time after coughing or removing a foreign body.

Neurosis of the pharynx

Specific changes in the sensitivity of the mucosa with its decrease or increase, pain, perspiration, itching, burning, a feeling of dryness, a lump predispose to the occurrence of a constant cough or episodes of a superficial hoarse cough in pharyngoneurosis. Characterized by "figurative", vivid complaints with a pronounced emotional reaction and vegetative symptoms (tachycardia, sweating). With a decrease in the sensitivity of the mucosa, choking and difficulty in swallowing are possible. In patients with increased pharyngeal reflex, coughing may induce vomiting.

thyroid cancer

An unproductive cough is one of the first symptoms of medullary thyroid cancer invading the larynx. The stage of superficial coughing is preceded by an increase in the cervical lymph nodes, which are palpated as immobile or inactive dense formations that form conglomerates with the skin. In the future, due to damage to the larynx, the voice becomes hoarse. Pressure on the organ from the outside provokes shortness of breath, difficulty breathing and passing food, an irritating sensation of the presence of a foreign body in the throat.

Complications of pharmacotherapy

Most often, an unproductive cough complicates the intake of certain groups of antihypertensive and antiarrhythmic drugs. A side effect in the form of a cough syndrome is observed on average in 15% of patients who use drugs to reduce pressure. In the group of long-term ill patients, this figure reaches 26%. For drug superficial cough, the appearance after taking the remedy is typical, aggravation in the morning, when lying down, movements and physical exertion. It is usually provoked by:

  • ACE inhibitors : captopril, capoten, irumed, zocardis.
  • β-blockers : atenolol, bisoprolol, metoprolol, trazikor.
  • Angiotensin receptor blockers : losartan, irbesartan, candesartan, valsartan.
  • Antiarrhythmic drugs : amiodarone, cardiodarone, arrhythmyl.


Since in most cases the presence of a superficial cough indicates damage to the upper respiratory tract, at the first stage of the diagnostic search, the condition of the nasal cavity, pharynx, larynx is clarified, and only after that other possible causes are excluded. The examination is usually organized by an ENT doctor who, according to indications, appoints consultations of specialized specialists. As screening recommended:

  • Instrumental methods of inspection . During rhinoscopy, pharyngoscopy and laryngoscopy, the condition of the mucosa of the upper respiratory tract is assessed. The examination reveals inflammatory processes, erosive changes, volumetric formations.
  • Microbiological and Serological Research . To search for pathogens, sowing smears from the nose, pharynx and laryngeal mucosa are used. Effective ways to confirm the infectious nature of cough and identify the pathogen are ELISA, RIF, PCR.

At the next stages of diagnosis, to exclude Zenker's diverticulum, contrast radiography of the esophagus and esophagoscopy are performed. With a presumed allergic origin of a superficial cough, allergy tests are prescribed. Ultrasound of the organ is an informative method for diagnosing malignant tumors of the thyroid gland. In the absence of organic causes of coughing, a neurological examination is recommended.

Instrumental examination of the upper respiratory tract


Symptomatic therapy

A cough caused by natural causes quickly disappears after the elimination of the irritating factor. Until the causes of a pathological superficial cough are clarified, antiseptic rinses, local anesthetics (when combined with sore throat and sore throat), moisturizing and softening inhalations can be recommended. Self-administration of antibiotics and antitussives is unacceptable. Persistent cough lasting more than 7-1 days, with increasing shortness of breath and swallowing disorders is an indication for emergency medical attention.

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