الفهرس 
DedicationOnly 14 pages are availabe for public view
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Abstract
Wheezing in infants is common and increasing in prevalence. Infants are particularly prone to wheezing due to developmental differences in airway mechanics compared to adults. These effects are enhanced in the presence of airway inflammation.
There are several different wheezing phenotypes:transient early wheezers, 60% of whom are not wheezing by the age of 6, show a strong association with maternal smoking during pregnancy, non-atopic wheezers have no change in their IgE status, and their wheezing relates to viral-induced peak flow variability, and persistent wheezers have raised IgE level at age 9 months and persists after the age of six years.
The differential diagnosis of the wheezing infant is quite extensive.Causes of wheezes in infancy and preschoolers include bronchiolitis, bronchitis, bronchial asthma, and congenital anomalies like tracheobronchomalacia, vascular rings, tracheoesophageal fistula,foreign body aspiration, GERD, BPD, cystic fibrosis, PCD, and other causes.
Diagnosing the wheezing infant is a complex and challenging task for even the most experienced physician. An accurate diagnosis depends on a medical history that includes possible risk factors such as exposure to maternal smoking, a thorough physical examination, and an understanding of the numerous differential diagnoses. The use of diagnostic tests such as the infant pulmonary function test along with a bronchodilator challenge, pH probe and/or bronchoscopy can guide the clinician for arriving at a correct diagnosis and the cause of wheezing in an infant.
The management of these patients, especially when symptoms are recurrent and severe, is a challenging task because of many difficult issues unique to this age group .Current practice tends to focus on confirming the presence of wheeze and distinguishing it from stridor and other upper airway noises and then prescribing therapy targeted at the most likely cause .