Christine Muglia1, John Oppenheimer2. 1. Rutgers New Jersey Medical School, The State University of New Jersey, 90 Bergen Street, Newark, NJ, 07103, USA. 2. Rutgers New Jersey Medical School, The State University of New Jersey, 90 Bergen Street, Newark, NJ, 07103, USA. nallopp@optonline.net.
Abstract
PURPOSE OF REVIEW: Wheezing in infancy is a common presentation with many potential causes. In writing this review, we sought to summarize the newest recommendations and testing available for the more common etiologies of wheezing. RECENT FINDINGS: Regarding the diagnosis of asthma, the modified asthma predictive index has recently been established as a useful predictive tool. Non-breath held multidetector CT with 3D volume rendering airway images is also a newer helpful diagnostic tool for tracheomalacia due to ease of use and its 100% positive predictive value. We found vaccines have greatly reduced the prevalence of epiglottitis, while advances in surgery are improving outcomes in infants with vascular rings. Wheezing in infants is a common problem with an extensive differential diagnosis from relatively benign to life threatening. To prevent over-looking a diagnosis that potentially requires surgical correction or emergent care, we recommend a structured approach to the history and physical exam with targeted testing directed towards the most likely diagnoses as outlined in this review.
PURPOSE OF REVIEW: Wheezing in infancy is a common presentation with many potential causes. In writing this review, we sought to summarize the newest recommendations and testing available for the more common etiologies of wheezing. RECENT FINDINGS: Regarding the diagnosis of asthma, the modified asthma predictive index has recently been established as a useful predictive tool. Non-breath held multidetector CT with 3D volume rendering airway images is also a newer helpful diagnostic tool for tracheomalacia due to ease of use and its 100% positive predictive value. We found vaccines have greatly reduced the prevalence of epiglottitis, while advances in surgery are improving outcomes in infants with vascular rings. Wheezing in infants is a common problem with an extensive differential diagnosis from relatively benign to life threatening. To prevent over-looking a diagnosis that potentially requires surgical correction or emergent care, we recommend a structured approach to the history and physical exam with targeted testing directed towards the most likely diagnoses as outlined in this review.
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