Wheezing in children

Last updated: October 20, 2022

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This article provides an overview of conditions causing wheezing in children. While acute wheezing in children may suggest a common cold, an acute asthma exacerbation, viral bronchiolitis, foreign body aspiration, anaphylaxis, acute bronchitis, or croup, recurrent or chronic wheezing may indicate a diagnosis of asthma, double aortic arch, primary ciliary dyskinesia, cystic fibrosis, tracheomalacia, or left-sided heart failure with cardiomegaly.

For more information on each specific condition, see the respective articles.

Acute wheezing in childrentoggle arrow icon

Differential diagnosis of acute wheezing in children


Characteristics Diagnostics
Common cold
  • Children < 6 years of age have an average of 6–8 common colds per year. [1]

Acute asthma exacerbation

Viral bronchiolitis
  • Primarily affects children < 2 years of age during winter [4]

Foreign body aspiration (FBA)

  • Primarily occurs in children < 3 years of age [5]
  • Occurs at any age
Acute bronchitis
  • Most common in children < 5 years of age [6]
Croup (laryngotracheobronchitis)
  • Peak incidence: 6 months to 3 years of age [7]

Chronic or recurrent wheezing in childrentoggle arrow icon

Differential diagnosis of chronic or recurrent wheezing in children


Characteristics Diagnostic findings
Double aortic arch
  • Congenital; manifests in first weeks of life [8]

Primary ciliary dyskinesia

  • Median age at diagnosis: 5.3 years [9]

Cystic fibrosis


  • Congenital; symptoms usually manifest at 4–8 weeks of age [11]
Left-sided heart failure with cardiomegaly

Referencestoggle arrow icon

  1. Benjamin I, Griggs RC, Fitz JG. Andreoli and Carpenter's Cecil Essentials of Medicine E-Book. Elsevier Health Sciences ; 2015
  2. Most Recent Asthma Data. Updated: February 27, 2017. Accessed: April 19, 2017.
  3. Mirabelli MC, Beavers SF, Chatterjee AB, Moorman JE. Age at asthma onset and subsequent asthma outcomes among adults with active asthma. Respiratory Medicine. 2013; 107 (12): p.1829-36.doi: 10.1016/j.rmed.2013.09.022 . | Open in Read by QxMD
  4. Piedimonte G, Perez MK. Respiratory syncytial virus infection and bronchiolitis. Pediatr Rev. 2014; 35 (12): p.519-530.doi: 10.1542/pir.35-12-519 . | Open in Read by QxMD
  5. Wang K-P, Mehta AC, Turner JF, Jr. JF. Flexible Bronchoscopy. John Wiley & Sons ; 2012
  6. Fleming DM, Elliot AJ. The management of acute bronchitis in children. Expert Opin Pharmacother. 2007; 8 (4): p.415-426.doi: 10.1517/14656566.8.4.415 . | Open in Read by QxMD
  7. Lowen AC, Mubareka S, Steel J, Palese P. Influenza virus transmission is dependent on relative humidity and temperature. PLos Pathog. 2007; 3 (10): p.1470-6.doi: 10.1371/journal.ppat.0030151 . | Open in Read by QxMD
  8. Shah RK, Mora BN, Bacha E, et al. The presentation and management of vascular rings: An otolaryngology perspective. Int J Pediatr Otorhinolaryngol. 2007; 71 (1): p.57-62.doi: 10.1016/j.ijporl.2006.08.025 . | Open in Read by QxMD
  9. Kuehni CE, Frischer T, Strippoli MPF, et al. Factors influencing age at diagnosis of primary ciliary dyskinesia in European children. European Respiratory Journal. 2010; 36 (6): p.1248-1258.doi: 10.1183/09031936.00001010 . | Open in Read by QxMD
  10. Accurso FJ, Sontag MK, Wagener JS. Complications associated with symptomatic diagnosis in infants with cystic fibrosis. J Pediatr. 2005; 147 (3): p.S37-S41.doi: 10.1016/j.jpeds.2005.08.034 . | Open in Read by QxMD
  11. Yang D, Cascella M. Tracheomalacia. StatPearls [Internet]. 2022.

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