The article about recurrent pneumonia by Owayed et al1 was very instructive. It would be interesting to know if the authors had any information regarding passive smoking, either from patient histories or cotinine levels. Passive smoking is a well-described risk factor for many pulmonary diseases and is much more common than some of the rare illnesses that the authors performed tests for.2 When considering risk factors for pediatric respiratory disease, especially potentially preventable risk factors, it is important to remember environmental tobacco smoke exposure.
Aligne CA. Recurrent Pneumonia in Children. Arch Pediatr Adolesc Med. 2000;154(8):850. doi: