Characteristics of episodic viral wheeze and of multiple trigger wheeze.
| ||Episodic viral wheeze||Multiple trigger wheeze|
|Definition||Wheezing during discrete time periods, often in association with clinical evidence of a viral cold||Wheezing that shows discrete exacerbations but also symptoms between episodes|
|Triggers||Viral infections||Viral infections, tobacco smoke, allergen exposure, mist exposure, crying, and exercise|
|Possible underlying factors||Preexistent impaired lung function, tobacco smoke exposure, prematurity, and atopy||Eosinophilic inflammation?|
|Continuing treatment with ICS||Little or no benefit||Significant fewer days with symptoms|
|Treatment with montelukast||Moderate benefit||Moderate reduction in exacerbations |
|Long-term outcome||Declines over time (<6 yrs) may continue into school age as episodic viral wheeze and may change into multiple trigger wheeze||May continue into adulthood as asthma|