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Annotations Consider other diagnoses

Consider other diagnoses

The NIH Expert Panel Report 2 identifies the following differential diagnostic possibilities for infants and children presenting with wheezing:

Upper airway diseases

  • Allergic rhinitis and sinusitis

Obstructions involving large airways

  • Foreign body in trachea or bronchus
  • Vocal cord dysfunction
  • Vascular rings or laryngeal webs
  • Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
  • Enlarged lymph nodes or tumor

Obstructions involving small airways

  • Viral bronchiolitis or obliterative bronchiolitis
  • Cystic fibrosis
  • Bronchopulmonary dysplasia
  • Heart disease

Other causes

  • Recurrent cough not due to asthma
  • Aspiration from swallowing mechanism dysfunction or gastroesophageal reflux (Expert panel report 2, p. 22).

Expert panel report 2. Guidelines for the diagnosis and management of asthma. (July, 1997). NIH publication no. 97-4051. Retrieved August 10, 2005, from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.

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