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Features suggestive of a diagnosis other than asthma in children with wheezing

Features suggestive of a diagnosis other than asthma in children with wheezing
History
  • Onset of symptoms in early infancy
  • Neonatal respiratory distress ± ventilatory support
  • Neonatal neurologic dysfunction
  • Intractable wheezing unresponsive to bronchodilators
  • Wheezing associated with feeding or vomiting
  • Difficulty swallowing ± recurrent vomiting
  • Diarrhea
  • Poor weight gain
  • Stridor
  • Oxygen requirement >1 week after acute attack
  • Food allergy
Physical examination
  • Failure to thrive
  • Clubbing
  • Cardiac murmur
  • Stridor
  • Focal lung signs
  • Nasal polyps
  • Crackles on auscultation
  • Cyanosis
  • Urticaria or other signs of anaphylaxis
Laboratory features
  • Focal or persistent chest radiograph abnormalities
  • Anemia
  • Irreversible airflow obstruction
  • Hypoxemia
Adapted from: Canny GJ, Levison H. Childhood asthma: A rational approach to treatment. Ann Allergy 1990; 64:406.
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