Asthma Mimickers: Approach to Differential Diagnosis.

The airway of a child can be easily obstructed because of its small size and there are myriad conditions that may obstruct it. Though asthma is the most common condition causing reversible obstruction of the airway; there are a large number of conditions which can obstruct the airway both reversibly and irreversibly. These asthma mimics can present as clinical problems from the neonatal period through adolescence. This article presents an overview of the clinical situations that must be kept in mind when the child presents with subtly unusual clinical features or a deviant course. This is followed by a brief description of the common mimickers along with clinical clues to their diagnosis. Clinicians will need a high index of suspicion for diagnosing these conditions. Prompt recognition and optimal case management and referral will ensure the best outcomes in these children.

Asthma: symptoms and presentation.

The goal of this article is to inform readers of the common and uncommon signs and symptoms of asthma. After completion of this article, readers should have a firm understanding of the symptoms and presentation leading to a diagnosis of asthma.

Quiste broncogénico. Diagnóstico a considerar en el lactante con síntomas respiratorios crónicos

El quiste broncogénico es una malformación de la porción ventral del intestino primitivo que ocasiona alteración en el desarrollo del árbol traqueo bronquial. Reportamos el caso de un lactante con síntomas respiratorios crónicos desde su nacimiento. El paciente fue referido a la consulta de neumología del Hospital del Niño con diagnóstico de asma de difícil control para ser evaluado y dar recomendaciones para su manejo ya que los síntomas respiratorios no mejoraban y seguía presentando recaídas a pesar del tratamiento para el asma. La historia clínica, el examen físico y los hallazgos de la radiografía de tórax hicieron sospechar una malformación congénita como un quiste broncogénico. Se realizaron estudios de gabinete que apoyaron el diagnóstico de un quiste broncogénico paratraqueal derecho. Se realizó la resección quirúrgica y el estudio histopatológico confirmó el diagnóstico. No hubo complicaciones y los síntomas respiratorios del paciente desaparecieron. Este caso es de interés porque permite hacer énfasis en la importancia del diagnóstico diferencial de los lactantes con síntomas respiratorios crónicos.

Bronchogenic cyst arises from abnormal budding of the diverticulum of the foregut that leads to abnormality of the tracheobronquial tree. We report a case of an infant with chronic respiratory symptoms since birth. The patient was referred to the outpatient pneumology clinic of the Hospital del Niño with the diagnosis of difficult control asthma for evaluation and recommendations due to respiratory symptoms which did not improve and persisted with relapses inspite of asthma treatment. The medical history, physical exam and radiographic findings of the chest x-ray raise the suspicion of a congenital malformation such as bronchogenic cyst. Studies which support the diagnosis of a right paratracheal bronchogenic cyst were performed. The patient underwent surgical resection and the histologic features confirmed the diagnosis. There were no complications and the patient´s respiratory symptoms disappeared. This case is of interest because it allows to emphasize the importance of the differential diagnosis of infants with chronic respiratory symptoms.