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Fifteen-minute consultation: An evidence-based approach to the child with preschool wheeze
  1. Renu Khetan1,
  2. Matthew Hurley1,2,
  3. Abraham Neduvamkunnil1,
  4. Jayesh Mahendra Bhatt1,3
  1. 1 Department of Paediatrics, Nottingham Children’s Hospital, Nottingham, UK
  2. 2 Division of Child Health, University of Nottingham, Nottingham, UK
  3. 3 Nottingham Children’s Hospital, National Paediatric Ataxia Telangiectasia Clinic, Nottingham, UK
  1. Correspondence to Dr Renu Khetan, Department of Paediatrics, Nottingham Children’s Hospital, Nottingham, NG 7, UK; Renu.Khetan{at}


Preschool wheeze is very common and its prevalence is increasing. It consumes considerable healthcare resources and has a major impact on children and their families due to significant morbidity associated with acute episodes.History taking is the main diagnostic instrument in the assessment of preschool wheeze. Diagnosis and management is complicated by a broad differential and associations with many other diseases and conditions that give rise to noisy breathing, which could be misinterpreted as wheeze. Several clinical phenotypes have been described but they have limitations and do not clearly inform therapeutic decisions. New insights in aetiopathogenesis modify treatment options and lay foundation for further research. An understanding of the approach and available evidence to assess and manage wheeze informs best patient care and use of resources.Our objective is to demonstrate a focused history, examination and management options in a preschool child with wheeze.

  • preschool
  • wheeze
  • risk factors
  • recurrence
  • inhaled corticosteroid
  • Montelukast

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.