August 1986

All That Wheezes Is Not Asthma

Author Affiliations

Head & Neck Physicians & Surgeons Clinic, P.A. 280 N Smith Ave, Suite 701 St Paul, MN 55102

Am J Dis Child. 1986;140(8):742. doi:10.1001/archpedi.1986.02140220024019

Sir.—Gay et al1 emphasized that a foreign body impacted in the subglottic area can present as croup, reactive airway disease, or upper airway obstruction, and that roentgenologic studies of the airway should be obtained in young patients who present with stridor or wheezing. However, it should be pointed out that even if results of these roentgenologic studies are normal, it is still necessary to proceed with endoscopic examination of the airway in young children who present with stridor and wheezing and who do not respond as expected to the usual methods of clinical management. The aphorism "all that wheezes is not asthma," remains just as true today as when it was first coined by Dr Chevalier Jackson.2 There are many pathologic conditions that masquerade as croup or asthma, and endoscopy of the airway is an essential diagnostic procedure in any child who does not respond to treatment

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