Cough

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A cough may bring up green or clear sputum from the chest or be non-productive and dry. Other symptoms which occur with a cough include breathlessness, chest pain and coryza (cold).

Causes

Frequently the cause is a simple cold, or a viral infection of the throat or, especially if the patient is a smoker, a bacterial bronchitis.

Green or yellow sputum for more than one or two days usually indicates a bacterial infection which will respond to treatment with antibiotics. These problems may be no more severe in someone with HIV than for anyone else, but in someone with more advanced HIV disease could lead to more serious infections in the chest if not treated early and adequately.

A cough which produces large amounts of sputum that is accompanied by pains in the chest, fever, weight loss and weakness should be investigated for possible tuberculosis. TB can occur in individuals with relatively high CD4 cell counts. See Tuberculosis in A to Z of illnesses for further details.

The main cause of concern in people with low CD4 counts (less than 200 cells/mm3) is PCP, an opportunistic infection of the lung. This typically causes a dry cough associated with fever and/or breathlessness. If the patient is taking adequate prophylactic treatment such as cotrimoxazole then the risk of this is much reduced.

Other relatively common causes of cough include tuberculosis and lesions in the throat or lungs due to Kaposi's sarcoma.

What to do

If cough is caused by Candida infection of the larynx it is easily treated with anti-fungal drugs. If the cough is associated with a cold or viral throat infection, simple over-the-counter remedies may bring some relief. If the cough is productive with green or discoloured sputum then treatment with antibiotics is usually necessary. If the cough is accompanied with the onset of breathlessness and/or chest pain and/or fever, the patient should see their doctor urgently for a proper diagnosis and treatment.

See also: Breathlessness.