Case Presentation :

• A 6-year-old female child was brought to the pediatric outpatient department with complaints of:
  1. Dry cough for 5 days associated with cold, sneezing, nasal congestion, and throat irritation.
  2. The cough was more prominent during nighttime and early morning hours, leading to disturbed sleep and irritability.
  3. According to the parents, symptoms began following exposure to seasonal weather changes and gradually progressed over several days.
  4. The child also experienced reduced appetite, mild fatigue, and discomfort during speaking due to throat dryness.

Past History :

1. There was no history of productive sputum, wheezing, breathing difficulty, chest pain, cyanosis, or high-grade fever.
2. There was no prior history of asthma, recurrent bronchitis, or allergy-related hospitalization.

Clinical Examination :

The child was conscious, cooperative, and mildly uncomfortable due to repetitive coughing episodes.

Vital Signs:

1. Temperature: 99°F
2. Respiratory rate: 24 breaths/min
3. Pulse rate: 96 beats/min
4. Oxygen saturation (SpO₂): 98% on room air0

Respiratory and ENT Examination :

1. Mild nasal congestion present.
2. Clear watery nasal discharge observed bilaterally.
3. Frequent sneezing episodes noted.
4. Mild pharyngeal erythema and throat irritation present.
5. Chest auscultation were found to be normal.

Chest Examination Revealed :

1. Bilaterally equal air entry
2. Normal vesicular breath sounds
3. No wheezing or crackles
4. No prolonged expiratory phase
5. Occasional dry cough triggered during examination

Diagnosis :

• Acute Viral Upper Respiratory Tract Infection with Dry Cough

Management :

• The patient was initiated on Dextromethorphan Hydrobromide + Chlorpheniramine Maleate + Phenylephrine Hydrochloride in Syrup formulation at a dose of 2.5 mL orally every 4 to 6 hours not to exceed 15 mL daily.

Supportive Measures:

1. Adequate oral hydration
2. Warm fluids
3. Steam inhalation
4. Rest and sleep optimization

Clinical Outcomes after Therapy

Within 4–5 days of treatment:

1. Significant reduction in dry cough frequency.
2. Improvement in nasal congestion and sneezing.
3. Resolution of throat irritation.
4. Improved nighttime sleep.