![]() Some will have persistent/interval symptoms between episodes of viral wheeze (cough and/or wheeze at night or with exercise) Supportive care involving monitoring adequate fluid intake (>50% of usual intake) and for signs of increasing respiratory distress ![]() Wheeze associated with respiratory tract infectionsīronchiolitis (usually in children 1 year of age and continue only if effective Very common, especially in the first 2 years of lifeĥ0% of children will have at least one wheezing episode 17 Viral wheezing (these include a spectrum of viral LRTIs that are not always clearly separated eg viral LRTI/recurrent viral-induced wheeze/bronchiolitis – management of episodes is identical and the distinction is sometimes arbitrary) Summary of the most common wheezing conditions in young children *Therapeutic benefit from asthma medications is poor for those 1-2 years of age and usually absent in the first year ICS, inhaled corticosteroids Algorithmic approach to young children presenting with wheeze in primary care A brief summary of the major wheezing conditions is provided in Table 1.įigure 1. The algorithm shown in Figure 1 considers the most common primary presentations with wheeze and gives one possible approach to this problem. Without a clear diagnostic label there is no single correct treatment approach and a diagnosis may become more certain depending on the treatment response. The family history of asthma/atopy and wheezing when active raises the possibility of early asthma however, sporadic coryzal symptoms also raises suspicion of intercurrent viral lower respiratory tract infections (LRTIs) and moist cough for months is suggestive of protracted bacterial bronchitis. In this case, the history of wheeze from birth suggests the possibility of tracheomalacia or bronchomalacia. The child is happy and thriving, and has a wet-sounding cough in clinic but no audible wheeze or respiratory distress on examination. History includes current eczema and a family history of asthma and allergies. The child’s mother had observed a regular wet cough and sporadic coryzal symptoms over this time, but is unsure of their exact duration. A child aged 2 years with a history of wheeze since birth that seemed to have improved by 1 year of age, now presents with a 6-month history (corresponding with colder months) of repeated episodes of wheeze, especially when active.
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