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Respiratory Disorders (Expert Forum)
Can you have asthma without wheezing?
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Can you have asthma without wheezing?
by KarenV, Dec 09, 2002 12:00AM
My son was recently diagnosed with asthma but has no wheezing. When he was three he developed a pleural effusion after we were told a small pneumonia had resolved. We were told this was probably due to inflammation caused by the infection. Now he is seven. He got a small pneumonia (one or two crackles before coughing) which we thought had been resolved by antibiotics as his fever went away and he felt much better. His cough did not go away after another 2 weeks, and in fact sounded wetter, so we went back to the doctor. She said both lungs were full of mucus and she felt inflammation caused him to be unable to clear this out. He began nebulizer treatments three times per day but it still has taken another couple of weeks to resolve the cough. She is now diagnosing him with asthma. She is recommending that we restart the nebulizer any time he develops a cough as she believes exposure to infections agents is his trigger. We are also supposed to bring him in within a day of restarting the nebulizer so that he can be monitored more closely. He never complained of tightness in his chest or difficulty breathing and has had no wheezing (other than a little wheeze during forced expiration). It sounds like his inflammation is more distal but I thought asthma involved the upper/larger airways. There is a lot of asthma in my husband's family but they all have more frequent episodes (asthma attacks) with wheezing and a dry cough. Is two episodes of inflammation after pneumonia in seven years, with no wheezing, asthma?
Doctor's Answer
by National Jewish, Dec 10, 2002 12:00AM
, Dec 10, 2002 12:00AM
NO is the answer to your final question “Is two episodes of inflammation after pneumonia in seven years, with no wheezing, asthma?” But, that does not mean that your son has or does not have asthma. This is much more complicated. Asthma is an inflammatory condition of the lung, including the small airways. While it usually has wheezing, it does not start that way in many people. Not everyone with asthma wheezes. Some people only cough. While it is usually fairly frequent, it can be an isolated event. Asthma is fairly easy to diagnose with pulmonary function testing in children who have reached school age. From what you have described, it is not clear that your son has or does not have asthma.
This time, my son is being treated with oralpred for 5 days, zythromax for the mycoplasma. He was also given a different inhaler called combivent. This inhaler helps to reduce the need to cough.
Hope this is helpful. I am hoping very much that my son doesn't develop asthma. My advice to you is to get a second opinion from a specialist.