Managing wheeze in preschool children: How difficult can it be?

Wheeze is a common symptom in infants and preschool children. Up to 30% of children wheeze at least once before the age of 3 years and 2% of those have it severe enough to warrant hospital admission. Not only parents but also physicians have difficulty in recognizing wheeze. Wrong diagnosis of the underlying condition leads to inappropriate and unnecessary management and patient morbidity. Asthma is the commonest underlying condition in children with wheeze, but the differential diagnosis is quite broad and a systematic approach including a good clinical history, thorough physical examination and appropriate investigations are essential to reach the accurate diagnosis.