Viral induced wheeze

Question 1

What is a VIW?

Answer 1

Acute wheezy illness caused by a viral infection.

Question 2

What is the difference between VIW and asthma?

Answer 2

• viral induced wheeze usually present before 3 years of age
• has no atopic history
• occurs only during viral infections
• asthma can be triggered by viral or bacterial infection but it also has other triggers eg. exercise, cold, dust, emotions

Question 3

How does VIW present?

Answer 3

Evidence of a viral illness (low grade fever, cough, and coryzal symptoms) for 1-2 days preceding the onset of shortness of breath, signs of respiratory distress, and expiratory wheeze throughout the chest.

Neither VIW nor asthma cause a focal wheeze (this may be a focal airway obstruction e.g. inhaled foreign body or tumour).

Question 4

What is the management for VIW?

Answer 4

• same as acute asthma in children
• Salbutamol inhalersvia aspacer device: starting with 10 puffs every 2 hours
• Nebuliserswithsalbutamol/ipratropium bromide
• Oralprednisone(e.g. 1mg per kg of body weight once a day for 3 days)
• supplementary oxygen
• IVhydrocortisone
• IVmagnesium sulphate
• IVsalbutamol
• IVaminophylline