title: Infantile wheeze: rethinking dogma.
abstract: Wheeze is a common symptom in young children and is usually associated with viral illnesses. It is a major source of morbidity and is responsible for a high consumption of healthcare and economic resources worldwide. A few children have a condition resembling classical asthma. Rarer specific conditions may have a wheezy component and should be considered in the differential diagnosis. Over the last half century, there have been many circular discussions about the best way of managing preschool wheeze. In general, intermittent wheezing should be treated with intermittent bronchodilator therapy, and a controller therapy should be prescribed for a young child with recurrent wheezing only if positively indicated, and only then if carefully monitored for efficacy. Good multidisciplinary support, attention to environmental exposition and education are essential in managing this common condition. This article analyses the pathophysiological basis of wheezing in infancy and critically discusses the evolution of the scientific progress over time in this unique field of respiratory medicine.
authors.affiliation: Salesi Children's Hospital Foundation, Ancona, Italy.
authors.forename: Fernando Maria
authors.initials: FM
authors.lastname: de Benedictis
authors.affiliation: Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.|National Heart and Lung Institute, Imperial School of Medicine, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D001424:Bacterial Infections / Q000150:complications; D001993:Bronchodilator Agents / Q000627:therapeutic use; D005544:Forecasting; D006801:Humans; D012135:Respiratory Sounds / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000150:complications
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents
keywords: infants; preschool children; wheezing