Fifteen-minute consultation: An evidence-based approach to the child with preschool wheeze

Arch Dis Child Educ Pract Ed. 2018 Feb;103(1):7-14. doi: 10.1136/archdischild-2016-311254. Epub 2017 Jun 30.

Abstract

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.

Keywords: Montelukast; inhaled corticosteroid; preschool; recurrence; risk factors; wheeze.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis*
  • Asthma / drug therapy*
  • Child, Preschool
  • Evidence-Based Medicine / methods*
  • Female
  • Humans
  • Infant
  • Male
  • Practice Guidelines as Topic*
  • Respiratory Sounds / diagnosis*
  • Respiratory Therapy
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents