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Evaluation of wheezing in infants and children

Author
Khoulood Fakhoury, MD
Section Editor
Gregory Redding, MD
Deputy Editor
Elizabeth TePas, MD, MS

INTRODUCTION

Wheezing is a common presenting symptom of respiratory disease in infants and children. One in three children experience at least one acute wheezing illness before the age of three years [1,2]. A nationwide survey performed in the United States between 1988 and 1994 showed that the prevalence for wheezing amongst two to three year olds was 26 percent and amongst 9 to 11 year olds was 13 percent [3-5]. Subsequent reports continue to show similar prevalence. In a 2007 survey in the US and Europe, a total of 9490 children aged one to five years were screened for respiratory symptoms [5]. Overall, 3077 (32 percent) reported recurrent cough, wheeze, or breathlessness in the preceding six winter months. The prevalence of these symptoms varied from 29 percent in Northern Europe to 48 percent in Southern Europe. The overall prevalence in the US was 27 percent. A large worldwide study looking at older children showed a global prevalence of wheezing of 11.6 percent in children aged 6 to 7 years and 13.7 percent in children between 13 to 14 years of age [4].

Wheezing may be either a benign, self-limited process or the presenting symptom of a significant respiratory disease [6]. The role of the treating clinician is to try to reach the most likely diagnosis as quickly and efficiently as possible so that therapy, if necessary, can be instituted and the parental concerns can be addressed.

A diagnostic approach to wheezing in childhood is presented in this topic review. Other topics that cover related areas include:

An overview of recurrent wheezing phenotypes in children (see "Wheezing phenotypes and prediction of asthma in young children")

The diagnosis and management of childhood asthma (see "Asthma in children younger than 12 years: Initial evaluation and diagnosis" and "Asthma in children younger than 12 years: Treatment of persistent asthma with controller medications")

                           
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Literature review current through: Nov 2017. | This topic last updated: Jul 10, 2017.
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