Hi, I'm Professor Andrew Bush from Imperial College and the Royal Brompton Hospital.
In this talk, I propose to cover the very difficult subject of Preschool Wheeze.
I have no relevant or irrelevant conflicts of interest
with regards to this presentation.
The aims of the presentation are to discuss the differential diagnosis of preschool children
presenting with wheeze and associated respiratory symptoms.
I will set out pathology and components of wheezing diseases in preschool children
and how we should be measuring them in the 21st century.
I will review treatment approaches in light of this
and also new data on inhaled and oral corticosteroids and azithromycin in particular.
So what conditions may mimic preschool wheeze and when should we consider them?
Cough and wheezes, by-and-large,
fall into one of five categories,
and you use the skills of your history and physical examination
to determine which category the child falls into.
The first category is normal child,
and this is the hardest diagnosis of all
and one you'll spend your life trying to learn how to make.
The next category is serious illness.
This is rare, particular in primary care,
but it's essential to get it right –
things like cystic fibrosis,
tuberculosis; the conditions will vary across the world.
The next group is an asthma syndrome,
which I will discuss,
the next group are minor problems such as rhinitis or reflux,
which may mimic or exacerbate wheezing symptoms,
and finally, the child, or family in particular,
who are over-anxious.