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Cough in children – how to assess, diagnose and treat




Dr Mattias Larsson. Photo courtesy of Family Medical Practice

Dr Mattias Larsson*

Thủy, a usually vibrant seven-year-old girl, had a persistent dry cough for three weeks, was tired, had decreased appetite, headaches, and low fever of 38oC. Hằng, Thủy’s mother, had taken her to local physicians and she had been treated with both cough syrup and antibiotics without any apparent effect except for diarrhea. As the mother was concerned and wanted a clear diagnosis, she took Thủy to Family Medical Practice for consultation.

Parents should consult clinics with capacity for differential diagnostics. — Photo

Coughing is one of the most common causes parents take their children to FMP. From the body’s point of view, coughing not a problem, but a solution! When irritants, such as mucus, foreign particles or pathogens enter the airways special receptors detect the irritant and a reflex response causes a forceful exhalation to expel the irritant, resulting in cough. 

When examining Thủy, the doctor noticed that the respiratory rate was faster than expected for her age, and she had inward chest movements, indicating that the body had to struggle to get enough oxygen. In the base of the right lung there was a crackling sound, crepitations, indicating that it might be some infection. 

When assessing symptoms you need to do a differential diagnosis between different causes. The first is to classify what kind of cough. Dry or productive with mucus? Force and frequency of coughing? Are there danger signs such as: High fever above 38,5oC? Difficulty or rapid breathing? In-drawings? Cyanosis with blue lips? Decreased appetite? Changes in consciousness?

What are the most common causes of coughing?

– Viral colds, the most common causes of childhood coughs, start with a runny nose that progresses to thicker mucus, possibly fever, usually resolves within a week with rest and symptomatic treatment.

– Bronchitis causes rapid breathing and chest in-drawings, is often viral, as RSV leading to high fever and respiratory distress in infants and young children. Treated with inhalation medication.

– Asthma causes airway restriction, cough, and difficulty breathing.

– Pneumonia presents with high fever, persistent cough and breathing problems, diagnosed with clinical evaluation, X-ray and blood tests, is often caused by bacteria that require antibiotics.

– COVID-19  causing cough, fever and respiratory symptoms, usually milder in kids than adults.

– Streptococcal Tonsillitis causes severe sore throat, pain when eating and drinking, cough and. Diagnosed with rapid strep-A test and treated with antibiotics.

– Allergic reactions trigger long-term coughing with transparent mucus, often also itchy eyes and runny nose. No fever. Managed by reducing exposure (pollen, mite, pollution,… ) and treated with antihistamine.

– Tuberculosis (TB), characterised by persistent cough, sometimes with blood, along with fever, weight loss and fatigue. Timely diagnosis and treatment is crucial.

– Whooping cough (Pertussis) causing severe coughing fits and often followed by a distinctive “whooping” sound during inhalation. Vaccination plays a vital role in prevention.

– Croup, presenting as a barking cough, hoarseness, and noisy breathing due to swelling of the upper airway. It is typically a viral infection and may require medical attention.

– Influenza A causes high fever, respiratory symptoms and body aches. Early diagnosis allows treatment with oseltamivir. Annual flu vaccination is recommended.

– Legionellosis, caused by the Legionella bacteria, starts with high fever, shivering, dry cough, breathing difficulties, chest pain, muscle aches and confusion, diagnosed with blood test, PCR. Treatment with antibiotics. 

As Thủy had persistent coughing, rapid breathing and crepitations, an X-ray was performed that showed infection in the lung. Blood tests indicated a bacterial infection, and a few hours later a rapid PCR test identified the culprit: Mycoplasma pneumoniae. Consequently, the correct antibiotic treatment was prescribed.

But why did Thủy not respond to the prior antibiotic treatment? That’s because Mycoplasma pneumoniae is an intracellular bacterium that does not respond to the most common antibiotics.

 A child’s cough can result from various causes, ranging from minor irritations to severe infections. Caregivers should be observant for danger signs such as rapid breathing, inward chest movements and persistent fever. Consulting a clinic with capacity for differential diagnostics is essential for an accurate diagnosis and appropriate treatment. Family Medical Practice

 *Dr Mattias Larsson is a paediatric doctor at Family Medical Practice and associate professor at Karolinska Institutet and has a long experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Vietnam. He is fluent in English, Swedish, Vietnamese, German, and some Spanish.

 Visit Family Medical Practice Hanoi 24/7 at 298I P. Kim Mã St, Kim Mã Ward, Ba Đình Dist. 

To book an appointment, please call us at (024).3843.0784 or via Whatsapp, Viber or Zalo on +84.944.43.1919 or email [email protected].

FMP’s downtown location in Hồ Chí Minh City is in Diamond Plaza, 34 Đ Lê Duẩn St, Bến Nghé Ward, District 1, and 95 Đ Thảo Điền St, District 2.  Tel. (028) 3822 7848 or email [email protected].



Your Vietnam

Tourists enjoy “Free walking tour” in Hải Phòng



Tourist pose for a photo at the Hải Phòng Railway Station. — Photo

HẢI PHÒNG — Every weekend the “Free Walking Tour” in Hải Phòng City attracts a large number of tourists due to its unique and captivating experiential value.

The Free Walking Tour is a travel concept offered by Vietravel Company in collaboration with the Hải Phòng Department of Tourism and Hải Phòng Railway Station. It aims to provide visitors with a “slow living” experience, allowing them to observe, feel and immerse themselves in the lives of the local people along each route.

During this tour, participants are guided by locals and provided with insights into the history, culture, architectural landmarks and the people of Hải Phòng. Additionally, they get to indulge in the culinary delights showcased on the Food Tour map.

The tour takes visitors to various attractions, including Tam Bạc Lake, the statue of General Lê Chân, a prominent figure who assisted the Trưng sisters in their resistance against foreign invaders from 40-42 AD, and the revitalised ancient An Biên Village, now known as Hải Phòng City. Other notable stops include the Hải Phòng Opera House, the City Museum and the Post Office.

Tourists enjoy a moment in Hải Phòng City. — Photo

On weekends, Hải Phòng Railway Station welcomes thousands of tourists. Visitors are provided with complimentary travel publications such as food tour maps, caps, t-shirts and promotional vouchers, enhancing their experience of dining and exploring the city.

In addition to promoting tourism through various digital platforms, the Hải Phòng Department of Tourism has launched a culinary map and a check-in location map to stimulate tourism demand. These initiatives aim to provide visitors with comprehensive tour experiences.

According to the municipal Department of Tourism, these tourism products are continuously evolving to offer tourists increasingly unique experiences during their food tours, thereby fostering a desire to revisit Hải Phòng. VNS


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Hải Phòng connects tourism with three Central Highlands provinces



Clear and peaceful beach on Monkey Island, Cát Bà Archipelago in Hải Phòng City. — Photo

HẢI PHÒNG — Hải Phòng City, in its efforts to boost tourism within the country, has established connections with three Central Highlands provinces.

According to Vũ Huy Thưởng, deputy director of Hải Phòng Department of Tourism, the city possesses several advantages in linking tourism with the Central Highlands provinces. This is made possible through the Hải Phòng – Buôn Ma Thuột route, as well as numerous flights connecting various provinces and cities nationwide.

Consequently, the Department of Culture, Sports, and Tourism of the three provinces will collaborate in promoting tourism development, enhancing coordination in showcasing and introducing destinations. Local tourism businesses will conduct research and develop products that capitalise on the unique potential and advantages of each locality. This collective effort aims to support the provinces and cities in accelerating their tourism industry’s sustainable and effective development, ultimately establishing them as alluring destinations on Việt Nam’s tourism map.

Hải Phòng City stands out due to its exceptional eco-tourism and island tourism offerings. Recognising the distinctive features of each location, fostering cooperation and partnerships with other regions becomes crucial in expanding markets and exchanging valuable insights for tourism development.

The Central Highlands, renowned for its abundant resources, boasts breathtaking landscapes and a vibrant indigenous culture. Home to 47 ethnic groups, the region holds significant cultural heritage such as the Central Highlands Gong Cultural Space, recognised as an intangible cultural heritage of humanity. Additionally, it hosts unique traditional festivals like the Elephant Racing Festival and Gongs Festival. VNS


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Your Vietnam

Valentin Constantinescu – a Romanian with ‘Vietnamese blood’



Trần Khánh An

Valentin Constantinescu, better known by his nickname Chiếc Tây Valentin, regards himself as “a Westerner from Romania with Vietnamese blood.” 

The Romanian man does not exaggerate or play on words – after nearly two decades in Việt Nam, he genuinely speaks Vietnamese fluently and profoundly understands this nation like a true Vietnamese.

Valentin Constantinescu, 38 years old from Romania, has lived in Việt Nam for 19 years. Photo courtesy of Valentin Constantinescu

His story with Việt Nam began in 2004 after graduating from high school, as he got a scholarship to study at the Diplomatic Academy of Việt Nam.

Valentin shared with Việt Nam News that he remembers vividly the heat and humidity of the ambience, as well as numerous motorcycles along the road to the student dormitory on the first day he set foot in Hà Nội.

Valentin was impressed by Hà Nội’s blend of tradition and modernity, which he described as “even more convenient than some developed countries.”

“I can go and stop anywhere, anytime on a motorbike with ease. Even shopping and dining are within easy reach,” he said.

“Even now, the payment system in Việt Nam is impressive,” Valentin added. “As bank transfers and QR code payments are more common, all you truly need to carry is a phone.”

“Vietnamese people are also friendly and hospitable. After the first week in Hà Nội, I decided I would never leave Việt Nam again.” 

Valentin led a team in “The Magic V” gameshow on VTV3 in 2022. Photo courtesy of Valentin Constantinescu

The 38-year-old now works as an English teacher and a content creator, producing content about Vietnamese culture and his experiences as an expat living in Việt Nam. This role earns him more than half a million followers on all social platforms. 

He has also participated in numerous gameshows and television programmes, winning over Vietnamese audiences with his sharp wit, conversational charm and profound knowledge of Việt Nam.

Valentin is also a chàng rể Hà Nội (Hà Nội’s son-in-law) — a term to describe a man marrying a Hà Nội’s woman. After he met his wife in 2016, Cupid immediately shot an arrow to match the couple up, and they married in 2018.

Valentin admitted that adjusting to his role as Hà Nội’s son-in-law was a bit challenging.

“My wife and I can have a loose timetable while we live together. When we visit our wife’s parents, however, we live in a more ordered manner,” he shared. 

“However, I believe that regularity and discipline in lifestyle are also unique characteristics of the Hà Nội people.”

Valentin’s seven-year multicultural marriage has given him a nuanced viewpoint of Eastern and Western traditions.

“I realise that both Eastern and Western culture are somehow constraining women,” he said.

In Việt Nam, unlike Western countries, it is not a custom that the wife must acquire her husband’s surname after marriage. However, it is a widely held belief here that when a woman marries, she is expected to care for her husband’s family more, as if her parents had lost a daughter.

“When my wife kept her Vietnamese last name, Phạm, I highly supported my wife’s decision and was so happy for her,” he recalled. 

“I also frequently encourage my wife to visit and take care of her family so that her parents do not feel like losing their daughter,” he added. 

“If I were a father, I would be happy if my daughter marries a wonderful spouse and has a happy life, rather than suffering with the pain of losing my child.”

Valentin supported his wife to keep her Vietnamese surname after marriage. Photo courtesy of Valentin Constantinescu

Due to the work change, Valentin and his wife moved to HCM City in 2018, and they miss Hà Nội weather and cuisine terribly. Hà Nội truly has cast him under its spell.

“The cold in Hà Nội and the sensation of being bundled up in layers of warm clothing, which also reminds me of Romania, is what I miss most,” Valentin recalled. 

“Southern food is a little bit sweet for me, whereas food in Hà Nội is perfect. While some may consider Hà Nội’s delicacies to be bland, the unique aspect of Hà Nội cuisine is that it empowers diners to season and customise their dishes with spices,” he added. 

Valentin and his wife both love cooking and share equal footing in the kitchen. She taught him how to prepare Vietnamese dishes, and now he could cook for their family and friends.

He prefers rolls because they are simple to prepare, as well as bordelaise sauce, which is not only a Hà Nội speciality but also reminds him of his time in Europe.

Valentin also hinted to Việt Nam News about his biggest project yet – he plans to travel across Việt Nam and spend at least a few months in each province to explore and introduce the people, culture, and cuisine.

Valentin intends to travel across Việt Nam, spending at least a few months in each province to explore and introduce the people, culture and local cuisine. Photo courtesy of Valentin Constantinescu

“I want to visit all provinces and cities across the country. I have only lived in two major cities; even when I travel, I have not completely immersed myself and lived as a native resident,” he revealed the reason behind his upcoming project.

As an expat who has lived in Việt Nam for nearly two decades, he is also confident that his unique viewpoint and extensive knowledge of his content can enrich the visitors’ experience compared to other foreign travelling vloggers – who may spend just a few weeks in Việt Nam. 

“I hope my videos will offer the audience valuable insights into local customs, culture, and cuisine, proving that Việt Nam is a place worth living.” VNS


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