Das giemende Kleinkind: Es ist nicht immer Asthma

Obstructive breathing disorders are a frequent reason for young children to be presented to a pediatrician’s office or pediatric emergency department and are also a frequent indication for inpatient treatment. They are clinically characterized by tachypnea with retractions, prolonged expiration and expiratory wheezing. The most frequent underlying causes in infants and young children are obstructive bronchitis or bronchiolitis and bronchial asthma; however, there are numerous other and sometimes serious conditions that can cause airflow obstruction and are often difficult to distinguish from obstructive bronchitis, bronchiolitis or bronchial asthma in this age group. They should be considered in the differential diagnostics particularly when symptoms persist during infancy, in cases of severe courses or failure to respond to treatment. The aim of this article is to provide an overview of important differential diagnoses, to show pitfalls, to illustrate differential diagnostic considerations and to describe diagnostic approaches.