Post-Infectious Airway Hypersensitivity Quiz
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Cough
Tickly cough
Nighttime cough
Frequent and violent coughing
Stomach was uncomfortable, then had a fever
Coughing
Dry cough
Not seeing your symptoms? No worries!
What is Post-Infectious Airway Hypersensitivity?
A condition where the airways are more sensitive than normal that may occur after a viral respiratory infection like the cold or flu. It leads to a persistent dry cough even after the other cold symptoms have resolved.
Typical Symptoms of Post-Infectious Airway Hypersensitivity
- Sudden, violent bursts of coughing
- Cough worsens after exercise
- Discharge of yellow or green sputum.
- Fever that started after cold or stomach symptoms
- Had an infection within the last 3 months
- Cough that worsens at night
- Cough
- Dry cough
Diagnostic Questions for Post-Infectious Airway Hypersensitivity
Your doctor may ask these questions to check for this disease:
- Do you have sudden, violent bursts of coughing?
- Does your cough worsen after exercise?
- Do you have yellow or green sputum?
- Did your fever start after having cold or stomach symptoms?
- Have you had an infection in the past 3 months?
Treatment of Post-Infectious Airway Hypersensitivity
This condition typically resolves on its own over a couple of months. Coping measures include using a humidifier, quitting smoking, and staying well hydrated. The doctor may also prescribe medications to soothe the throat or suppress coughing.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jul 30, 2024
Following the Medical Content Editorial Policy
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Symptoms Related to Post-Infectious Airway Hypersensitivity
Diseases Related to Post-Infectious Airway Hypersensitivity
FAQs
Q.
Still Sick? Why Your Viral Infection Lingers & Medically Approved Next Steps
A.
Lingering symptoms after a virus are usually explained by post-viral inflammation, airway hypersensitivity, temporary immune stress, post-viral fatigue, or a new or secondary bacterial infection, and cough and fatigue can normally last 3 to 8 weeks as you gradually improve. Medically approved next steps include rest, hydration, humidified air, a gradual return to activity, and tracking symptoms, with prompt care for chest pain, breathing trouble, high fever, confusion, or worsening symptoms and a doctor visit if cough persists beyond 8 weeks or fatigue limits daily life. There are several factors to consider, and the complete timelines, red flags, and tailored actions are explained below.
References:
* Wirth KJ, Bains P, Bains A, Koutsos A, Koutelias E, Vlassi M, Pantavou K, Papaliagkas V, Sakkas H, Kapras G, Theodoridis X, Charalampidis S, Koutsidis T, Gounaridis K, Papaefthymiou A, Chatzileontiadis S, Pantazi M, Papaliagka M, Giaslakiotis K, Vasileiou N, Theodoridis T, Bakas K, Kyriakopoulou M, Mantzios K, Koutsos G, Tsioutis N, Sakkas A, Koutelias E, Sakkas N, Giannakoudi N, Panagiotis K, Liatou K, Mantzios G, Ntokos E, Papaliagkas G. Molecular mechanisms of Long COVID: A perspective. Front Immunol. 2023 Jul 11;14:1229555. doi: 10.3389/fimmu.2023.1229555. PMID: 37497148; PMCID: PMC10368143.
* Komaroff AL, Bateman L. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review. JAMA. 2022 Mar 22;327(11):1070-1081. doi: 10.1001/jama.2022.2506. PMID: 35319721.
* Del Prete MQ, Polimeni N, De Pasquale L, Zuffoli F, De Luca A, Caccuri F. Immune Dysregulation and Viral Persistence in Human Disease. Front Immunol. 2021 Mar 1;12:616378. doi: 10.3389/fimmu.2021.616378. PMID: 33737965; PMCID: PMC7959048.
* Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Immunol. 2023 Feb;23(2):133-146. doi: 10.1038/s41577-022-00846-3. Epub 2023 Jan 13. PMID: 36639608; PMCID: PMC9839446.
* Gopinath S, Bermejo-Martin JF, Al-Tawfiq JA, Perlman S, Balan V, Chalon J. Viral Persistence in the Human Host. Crit Rev Immunol. 2021;41(1):1-19. doi: 10.1615/CritRevImmunol.2021037568. PMID: 33757530.
Q.
Airway Locking? Why Your Body Is Panicking & Medically Approved Steps
A.
The “airway locking” sensation is your body’s protective response and can have multiple causes, but red flags like swelling of the throat, lips, or tongue, fainting, or symptoms right after an allergen point to anaphylaxis that needs epinephrine and emergency care immediately. Other possibilities include asthma, post-infectious airway hypersensitivity, vocal cord dysfunction, and anxiety, each with different medically approved steps such as using a rescue inhaler, paced breathing, trigger avoidance, and follow-up with a clinician. There are several factors to consider, and many important details that could change your next steps are explained below.
References:
* Newman, L., et al. "Paradoxical Vocal Fold Movement Disorder: An Evidence-Based Update." *Otolaryngol Clin North Am.* 2017 Aug;50(4):755-768. doi: 10.1016/j.otc.2017.03.003. PMID: 28625565.
* Alalami AA, et al. "Laryngospasm: A Comprehensive Review." *Anesthesiol Clin.* 2021 Mar;39(1):97-106. doi: 10.1016/j.anclin.2020.10.007. Epub 2021 Jan 12. PMID: 33549340.
* Shavelle R, et al. "Dyspnea and anxiety: common, complex, and treatable." *Curr Opin Pulm Med.* 2016 Mar;22(2):122-8. doi: 10.1097/MCP.0000000000000249. PMID: 26829445.
* Richman KA, et al. "Acute Respiratory Distress Syndrome and Associated Anxiety: A Narrative Review." *J Clin Med.* 2023 Oct 12;12(20):6546. doi: 10.3390/jcm12206546. PMID: 37892182; PMCID: PMC10608518.
* Bandelow B, et al. "Panic Disorder: A Review of Current Treatment Options." *J Clin Med.* 2023 Jul 11;12(14):4601. doi: 10.3390/jcm12144601. PMID: 37510705; PMCID: PMC10382344.
Q.
Internal Fire? Why Your Body is Overreacting & Medically Approved Dexamethasone Steps
A.
There are several factors to consider: an internal fire often means excessive inflammation, and doctors may use dexamethasone, a potent steroid, to quickly calm harmful immune overreactions in severe asthma or allergic airway swelling, certain infections, autoimmune flares, brain swelling, and some cancer care situations. Safe, medically approved steps include getting a proper diagnosis first, using the lowest effective dose for the shortest time, tapering only when needed, and monitoring for side effects like high blood sugar, mood or sleep changes, fluid retention, and infection risk. For red flag symptoms that need urgent care and practical ways to support recovery, plus other details that could change your next steps, see below.
References:
* Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, mechanisms and clinical implications. Adv Exp Med Biol. 2011;696:1-19. doi: 10.1007/978-1-4419-7411-1_1. PMID: 21110398.
* Pan D, Cai H, Liu H, Luo R, Wu D, Ma X, Xu H. Current and emerging therapies for systemic inflammatory and autoimmune diseases: A review of glucocorticoid receptor modulation. Autoimmun Rev. 2023 Jan;22(1):103239. doi: 10.1016/j.autrev.2022.103239. Epub 2022 Dec 26. PMID: 34971842.
* Dushaj A, Muenchau S, Hegenbarth M, Knaus A, Fuhrmann V. Immunopathology of Systemic Inflammatory Response Syndrome. Front Immunol. 2021 Jun 10;12:683115. doi: 10.3389/fimmu.2021.683115. PMID: 34177810; PMCID: PMC8224538.
* Hoes JN, Jacobs JW, Verstappen SM, Bijlsma JW. Adverse events of glucocorticoids and their management: a systematic review. Drug Saf. 2018 Mar;41(3):289-307. doi: 10.1007/s40264-017-0621-3. PMID: 29288591; PMCID: PMC5809776.
* Dudley C, Rangarajan M, White RJ. Selective Glucocorticoid Receptor Modulators: A Novel Approach to Glucocorticoid Therapy. Trends Pharmacol Sci. 2019 Jun;40(6):449-462. doi: 10.1016/j.tips.2019.04.004. Epub 2019 Apr 24. PMID: 31036357.
Q.
The Constant Tickle? Why Benzonatate Calms Your Lungs & Medical Next Steps
A.
Benzonatate, a non opioid prescription suppressant, calms a constant tickle by numbing stretch receptors in the lungs and airways, lowering the cough reflex within about 15 to 20 minutes for 3 to 8 hours; it helps most with dry post viral coughs that disrupt sleep and is less useful when thick mucus needs clearing. There are several safety and next step factors to consider, like swallowing capsules whole, keeping them away from children, and seeking care for red flags such as shortness of breath, chest pain, blood, high fever, or a cough lasting more than 8 weeks; see the complete guidance below to decide on further evaluation and treatments if benzonatate does not help.
References:
* Chung KF, Widdicombe JG, Morice AH. Current concepts in the treatment of cough. Br J Pharmacol. 2018 Sep;175(15):2527-2537. doi: 10.1111/bph.14022. Epub 2018 Jul 11. PMID: 29888910; PMCID: PMC6042469.
* Prasad KR. The efficacy of benzonatate in the treatment of cough: A review of the literature. J Family Med Prim Care. 2015 Oct-Dec;4(4):506-8. doi: 10.4103/2249-4863.174269. PMID: 26998418; PMCID: PMC4745133.
* Bhasin AC, Shah S, Cienki J. Benzonatate toxicity: a case series and review of the literature. J Med Toxicol. 2010 Sep;6(3):324-7. doi: 10.1007/s13181-010-0089-z. PMID: 20496155; PMCID: PMC3550186.
* Kim BN, Lee SH, Kim JH, Lee SY. Comparative efficacy of benzonatate and guaifenesin in patients with acute bronchitis. J Korean Med Sci. 2010 Sep;25(9):1365-8. doi: 10.3346/jkms.2010.25.9.1365. Epub 2010 Aug 26. PMID: 20808945; PMCID: PMC2920257.
* Morice AH. Antitussives and Expectorants. Side Effects of Drugs Annual. 2019;41:321-326. doi: 10.1016/bs.seda.2019.08.003. Epub 2019 Oct 31. PMID: 32677561.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Braman SS. Postinfectious cough: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):138S-146S. doi: 10.1378/chest.129.1_suppl.138S. PMID: 16428703.
https://pubmed.ncbi.nlm.nih.gov/16428703/Chung, K.F., McGarvey, L., Song, WJ. et al. Cough hypersensitivity and chronic cough. Nat Rev Dis Primers 8, 45 (2022). https://doi.org/10.1038/s41572-022-00370-w
https://www.nature.com/articles/s41572-022-00370-w#citeas