Clinical investigations from the RACP

Investigating wheeze in children

Ray Nethercott, Craig Mellis

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Abstract

Wheeze is extremely common in infancy and early childhood. A thorough history and physical examination will usually determine the cause of the wheeze, but in some cases further investigations may be needed.

Key Points

  • Wheeze in infancy is not usually due to asthma.
  • A thorough history and physical examination will generally determine the cause of the wheeze.
  • Pulmonary function testing (FEV1 and PEF) can be performed reliably in most children over 5 to 6 years of age and is useful if there is uncertainty regarding diagnosis or disease severity.
  • In toddlers and preschool children always consider the possibility that an inhaled foreign body is the cause of wheezing.
  • While not a routine investigation, a chest x-ray can be useful in all age groups to exclude most rare and serious causes of wheeze.

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