Akuter und chronischer Husten – Differenzialdiagnose und Behandlung

Husten ist ein häufiger Konsultationsgrund in der hausärztlichen Praxis. Meist ist das Symptom harmlos und selbstlimitierend wie z. B. bei einem banalen Erkältungshusten – jedoch können auch schwerwiegende Erkrankungen wie Malignome die Ursache sein. Die Abklärung ist daher nicht immer einfach. Dieser Beitrag stellt ein gezieltes und angemessenes Vorgehen dar und diskutiert, welche Behandlungen empfohlen und effektiv sind.

Abstract

Cough is a frequent reason for consultation in the general practitionerʼs office. Most of the time, the symptom is harmless and self-limiting, as in the case of a banal cold cough, for example – however, serious diseases such as malignancies can also be the cause. Evaluation is therefore not always easy. This article presents a targeted and appropriate approach and discusses which treatments are recommended and effective.

Acute and chronic cough are differentiated according to the duration of symptoms (up to 8 weeks/longer than 8 weeks). The most common cause of acute cough is a self-limiting viral infection of the upper respiratory tract; the most important differential diagnosis is community-acquired pneumonia. If there are no defined warning signs (red flags), the history and clinical examination are sufficient to establish the diagnosis in the case of an acute cough; medication is not necessary. In the case of a chronic cough, a chest X-ray is usually ordered and then further investigations are carried out in accordance with the most probable suspected diagnosis; probationary therapies are an important part of the workup. Coughs that are refractory to treatment or unexplained require individualised treatment (pharmacological, including off-label, non-pharmacological) and regular re-evaluation.

Schlüsselwörter

akuter Husten - chronischer Husten - Hausarztpraxis - Differenzialdiagnose

Key words

acute cough - chronic cough - family practice - differential diagnosis

Publication History

Article published online:
01 August 2022

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