4.5 year old w/ 5 month dry cough that doesn't respond to asthma or anti-reflux meds or abx. classic asthma triggers but no wheezing? pertussis neg.

Post-nasall drip: Persistant cough is 95% of the time a combination of reflux, cough-variant asthma and/or post-nasal drip. The PND can be caused by allergy, chronic low grade sinusitis or non-allergic rhinitis. If all these problems have been excluded the child needs a thorough evaluation by either an allergist or pulmonologist who is experienced with children.

Allergic rhinitis?: Allergic rhinitis or chronic sinusitis and post-nasal drip are the next most common cause for the above symptoms. If you don't control the upper airway problem, the cough and asthma will never go away. I suggest decongestant, nasal steroid, allergy testing and removal of all triggers from the environment, if that doesn't help - see ent.

Postnasal drainage: It sounds like your child has a couple of triggers. Most common causes of dry chronic cough are postnasal drainage, airway bronchospasms, and gastroesophageal reflux disease. Usually the cough from bronchospasms is at night, waking the child up from sleep, and related to activities. The cough from reflux is usually when the child lays down initially. Postnasal drainage cough occurs after an in.