Coughing is a natural reflex that helps to clear the airways of mucus and other irritants. Coughs can occur due to a simple irritation in the throat, or they may develop in response to an infection or inhalation of a foreign object.
This article outlines the various causes of a cough without a fever, along with their associated treatments. We also provide advice on home remedies and when to see a doctor.
Coughing is a natural reflex that helps clear the airways of mucus and other irritants.
There are two basic types of cough: productive and non-productive.
Productive coughs, or wet coughs, produce mucus, whereas non-productive coughs, or dry coughs, do not produce mucus.
Coughs also differ according to their severity and duration.
The National Heart, Lung, and Blood Institute indicate that coughs can be:
- Acute: Lasting 3 weeks or less.
- Sub-Acute: Lasting 3-8 weeks and persisting after the infection that caused them has gone.
- Chronic: Lasting longer than 8 weeks. This type can occur due to chronic respiratory conditions.
Below are some potential causes of a cough without a fever.
Adults typically get two to three colds a year, and most of these occur due to a group of viruses called rhinoviruses.
The common cold may cause a mild to moderate cough, usually without a fever. Other possible symptoms of a cold include:
The common cold usually goes away within a week or two without the need for medical treatment.
However, a person can take over-the-counter (OTC) medications to help to alleviate the symptoms.
Gastroesophageal reflux disease (GERD) is a condition in which stomach acid and other stomach contents frequently leak out of the stomach and back into the esophagus. The esophagus is the tube that connects the mouth and stomach.
Acid reflux can irritate the lining of the esophagus, triggering a cough.
Other possible symptoms include:
- pain or difficulty when swallowing
- pain in the chest or upper abdomen
- bad breath
- erosion of tooth enamel
The following lifestyle changes may help people to manage GERD:
- quitting smoking
- avoiding or limiting alcohol
- avoiding overeating
- avoiding eating within 2–3 hours of going to bed
- avoiding eating greasy, fatty, or spicy foods that may trigger GERD
- losing weight if necessary
If lifestyle changes do not lead to an improvement in GERD, a person may require OTC or prescription medications.
Postnasal drip is where excess mucus builds up in the back of the sinuses and trickles down the back of the throat. This trickling can irritate the throat, causing a person to cough.
Other possible symptoms of postnasal drip include:
- sore throat
- bad breath
The following home treatments may help to alleviate the symptoms of postnasal drip:
- keeping hydrated
- using a humidifier or inhaling steam
- using a nasal irrigator to flush out the sinuses
Whooping cough requires treatment with antibiotics.
Prompt treatment will help lessen the severity of the illness and reduce the risk of passing the infection on to others.
In some cases, a person can experience a cough without fever after the initial infection has resolved.
According to one 2016 article, inflammation increased mucus production, and damage to the upper and lower airways can cause a post-infectious cough.
A person may experience a post-infectious cough after the following conditions:
- Bronchitis: This is the medical term for inflammation of the airways. Bronchitis typically causes a productive cough, along with a low-grade fever. However, the cough can persist for several weeks after the fever has gone.
- Whooping cough: This is a bacterial infection of the lungs and airways. The condition can cause violent coughing fits that cause a person to gasp for air. Whooping cough may also cause a low-grade fever, but this typically goes away long before the cough disappears. The cough may last for up to 10 weeks or more.
- Croup: Croup is a type of respiratory infection that causes swelling of the windpipe or “trachea.” The initial symptoms of croup may include fever. As the condition progresses, the fever may diminish, but a “barking” cough and hoarseness may appear.
Treatment for a post-infectious cough includes medication, such as:
- dextromethorphan, which is a cough suppressant
The cause of a cough without fever in children can be the same as those for adults. However, certain causes are more common in children than in adults. We outline some causes below.
Children may put objects in their mouth out of curiosity or experimentation or to alleviate the discomfort of teething. If a child accidentally inhales a small object, it can become trapped in the airways. This can lead to coughing.
In some cases, coughing helps to dislodge the object from the child’s airways.
In other cases, the object may cause a complete blockage of the airways, which results in choking. This is a medical emergency. A child who is choking will be unable to cough, cry, or breathe.
If a child has inhaled an object and is coughing, the act of coughing should help to dislodge the object.
However, a child who is showing signs of choking will require emergency treatment to dislodge the object. The treatment will depend on the age of the person who is choking.
Children and adults over 1 year of age will require the Heimlich maneuver. Babies younger than 1 will require rescue back blows and chest thrusts.
Nervousness or anxieties
Some children may clear their throats when nervous or anxious. Some people refer to this as a “habit cough.”
The treatment for a habit cough may involve:
- reassuring the child during times of stress or anxiety
- distracting the child during a coughing episode
- talking therapy to determine the cause of stress and anxiety
When diagnosing the cause of a cough without fever, a doctor will ask about the symptoms a person is experiencing. They may also carry out a physical exam, during which they will use a stethoscope to listen for any unusual sounds in the lungs.
A doctor may also recommend other diagnostic procedures, including:
- a chest X-ray or computerized tomography (CT) scan to check for fluid or abnormalities in the lungs
- allergy tests to determine whether the cough is due to an undiagnosed allergy
- a sputum test to check for the presence of infectious pathogens
- blood tests to check for infections or inflammation
An acute cough may sometimes improve following home treatment, such as:
- using a humidifier to keep the air moist
- taking hot showers to help alleviate congestion and open the airways
- drinking plenty of fluids, such as hot tea with honey to soothe irritation
- getting plenty of rest to help the body fight an infection
Some people may also find relief by using OTC medications, such as:
- cough syrups
- throat lozenges
- saline nasal sprays
Certain cough and cold medications are not suitable for children. A person can discuss suitable options with their pharmacist or doctor.
Coughs should improve without medical intervention in 3–4 weeks. However, if a cough persists beyond 4 weeks, a person should see their doctor for a diagnosis.
A person should also see their doctor if any of the following symptoms accompany their cough:
Coughing can occur for many different reasons. A cough that occurs without a fever may be due to a simple irritation in the throat, or inhalation of a foreign object. It may also be a symptom of an infection.
Coughs that are due to an infection are often accompanied by a fever.
However, in some cases, people will not develop a fever. In other cases, the cough is a symptom that persists long after the initial fever has passed.
If a person does not notice an improvement in their cough after several weeks, they should see a doctor for a diagnosis and appropriate treatment.
People should also seek medical attention for accompanying symptoms, such as chest pain, shortness of breath, and increased mucus production.