We all cough from time to time. Sometimes we simply have a scratchy throat, and especially during the winter months we cough due to colds and flu. We rarely pay too much attention to a cough and it usually goes away after a few days.

But when is a cough more than just a frog in your throat, or a symptom of the common cold? In serious diseases such as asthma, tuberculosis and chronic obstructive pulmonary disease (COPD) a cough is often the first indication that something is seriously wrong.

Due to intensive public awareness campaigns, many people are familiar with these disorders, but unfortunately not all dangerous conditions associated with a cough are “front of mind”. Here are seven dangerous conditions you should consider when you are suffering from a cough. Although some of these are rare, it’s worth checking them out.

1. Lung cancer

We know that smoking is a big risk factor for developing lung cancer, but even non-smokers can be at risk. Lung cancer starts when abnormal cells grow in the bronchial walls, according to a Health24 review. Coughing can be a sign of cancer and is caused by intrabronchial protrusion of the tumour. This lesion may change the character of sound in chronic coughers to a “brassy” sound. Research from the Sheffield Hallam University indicates that you should go to the doctor if a new cough persists for more than three weeks. At an advanced stage sufferers are likely to cough up blood, which is an urgent indicator that you should get medical attention.

2. Cystic fibrosis

Cystic fibrosis is an inherited disease characterised by abnormally thick, sticky mucus that prevents organs such as the lungs and pancreas from working correctly. According to The Cystic Fibrosis Foundation “the mucus clogs the airways and traps bacteria, leading to infections, extensive lung damage, and eventually, respiratory failure”. Thick sputum (substance produced by coughing or clearing the throat), and a chronic cough and wheezing are signs of this disease.

3. Atelectasis

Atelectasis occurs when one or more areas of your lungs collapse or don’t inflate properly. It can be due to an accumulation of mucus in the airways, and coughing might actually bring some relief. Coughing might be more severe than is normal for you, according to the National Heart, Lung and Blood Institute, and this can be an indicator of the condition.

4. Congestive heart failure

Some conditions cause immediate and noticeable harm, but other ones like congestive heart failure (CHF) usually develop over time. Sufferers’ hearts are unable to pump blood effectively and/or prevent blood from accumulating in the lungs. An early symptom of the disease is a dry, hacking cough, especially when lying down. A Health24 review shows CHF should not be ignored as it can lead to a heart attack, and ultimately death.

5. Sarcoidosis

Sarcoidosis is an inflammatory disease that affects many organs in the body. A study by the Foundation for Sarcoidosis Research found that it triggered heightened immunity, “which means that a person’s immune system, which normally protects the body from infection and disease, overreacts and damages the body’s own tissues”. When sarcoidosis affects the lungs (also called pulmonary fibrosis) inflammation can scar lung tissue leading to reduced oxygen levels. A dry cough that persists, and struggling to breathe are potential signs of this disease.

6. Pulmonary oedema

Pulmonary oedema means that there is excess fluid in the lungs. The fluid collects in the air sacs, making it difficult to breathe. A cough that produces sputum with small bubbles can be a sign of pulmonary oedema, research from the University of Maryland found. It is advisable to consult a doctor when you produce pink, frothy sputum during a cough.

7. Acute respiratory distress syndrome

SARS (Severe Acute Respiratory Syndrome) is a contagious and sometimes fatal viral respiratory illness, according to a Health24 review. Symptoms are similar to those of other respiratory illnesses like flu and pneumonia. The disease is transferred when a person coughs, and a chronic, persistent cough might be a sign of SARS. Consult a doctor if you struggle to get rid of a cough.

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You are quickly running out of tissues for both your runny nose and your watery eyes. You suspect it is your allergies acting up again, but how do you know it’s not sinusitis?

Distinguishing between symptoms that could be either sinusitis or an allergy is something with which even medical professionals can sometimes struggle. According to Health24’s Cyberdoc Dr Heidi van Deventer, “Allergic rhinitis and sinusitis are indeed difficult to tell apart, especially at the start.

The symptoms are mostly the same, such as sneezing, a runny nose, itchy ears, and sometimes even feelings of vertigo due to an imbalance of fluid in the sinuses, nasal passages and ears.”

Clearing up the confusion

According to Health24, infection in the sinuses causes irritation and inflammation of the sinus linings. The inflammation can cause blockages, obstructing the drainage of mucus inside the sinus cavities.

Dr van Deventer explains the following:

• Sinusitis can make one very ill and at its worst needs to be treated with strong antibiotics for up to 10 days.
• It can cause severe headaches and pressure in the sinuses, as well as systemic illness with body aches and fever.
• Sinusitis can also start as allergic rhinitis and then, if the mucus is not cleared sufficiently, it can become infected with bacteria and cause bacterial sinusitis, so sinusitis can be caused by a virus or bacteria.

Allergic rhinitis is caused by various environmental factors, such as pollen in the air or the hair of pets like cats or dogs. Allergic rhinitis will usually clear up with antihistamine and a nasal spray, and will improve when the irritant is removed from the environment.  

A few questions to ask when you are struggling to figure out if you have allergic rhinitis or sinusitis:

Q: Have you been exposed to any substance recently that could have caused the allergies, such as flowers, pet hair etc.?

A: If yes, it is quite likely that you have allergic rhinitis.

Q: How long have you had the symptoms?

A: If symptoms persist for more than a few days it could be a sinus infection.

Q: What does the discharge look like?

A: If it’s clear, thin and watery, it probably isn’t an infection, which would indicate that you are experiencing an allergic reaction.

Once you have a better idea of what caused your condition, you or a medical professional will be able to more effectively treat your sinusitis or allergies.

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Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute