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
