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Unusual cause of dyspnoea
  1. Nicola Ullmann1,
  2. Giulia Ceglie1,
  3. Maria Giovanna Paglietti1,
  4. Sergio Bottero2,
  5. Renato Cutrera1
  1. 1Department of Pediatrics, Pediatric Hospital ‘Bambino Gesù’, Rome, Italy
  2. 2Laryngotracheal Team, Airway Surgery Unit, Bambino Gesù Children's Hospital, Rome, Italy
  1. Correspondence to Dr Giulia Ceglie, Department of Pediatrics, Bambino Gesù Children’s Hospital, Piazza S.Onofrio, Rome 00165, Italy; giulia.ceglie{at}gmail.com

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A 4-year-old boy was admitted to our department with fever, cough and dyspnoea, unresponsive to salbutamol and antibiotic therapy. He had previously contracted bronchiolitis at 20 days of life, followed by intermittent episodes of wheeze that never required hospitalisation and responded to short inhaled corticosteroid cycles. He had an atopic family history. On examination, he had dyspnoea, persistent cough with bronchospasm but normal oxygen saturations. Bloods showed elevated eosinophils (2004 µL), a slightly elevated C-reactive protein (1.5 mg/dL) and total IgE (326 kU/L), and specific IgE was raised for various inhalant allergens (box). A chest X-ray was performed (figure 1).

Box

Positive inhalant allergens

  • Anthoxanthum odoratum

  • Cynodon dactylon

  • Dactylis glomerata

  • Dermatophagoides farinae

  • Dermatophagoides pteronissimus

  • Holcus lanatus

  • Poa pratensis

  • Phleum …

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