Table 1.
Characteristics of episodic viral wheeze and of multiple trigger wheeze.
| Episodic viral wheeze | Multiple trigger wheeze | |
|---|---|---|
| Definition | Wheezing during discrete time periods, often in association with clinical evidence of a viral cold | Wheezing that shows discrete exacerbations but also symptoms between episodes |
|
| ||
| Triggers | Viral infections | Viral infections, tobacco smoke, allergen exposure, mist exposure, crying, and exercise |
|
| ||
| Possible underlying factors | Preexistent impaired lung function, tobacco smoke exposure, prematurity, and atopy | Eosinophilic inflammation? |
|
| ||
| Continuing treatment with ICS | Little or no benefit | Significant fewer days with symptoms |
|
| ||
| Treatment with montelukast | Moderate benefit | Moderate reduction in exacerbations |
|
| ||
| Long-term outcome | Declines over time (<6 yrs) may continue into school age as episodic viral wheeze and may change into multiple trigger wheeze | May continue into adulthood as asthma |