Overview
Viral-induced wheeze (VIW) describes wheezing due to a viral infection (such as respiratory syncytial virus, RSV). Infection can lead to inflammation and oedema of the airways, reducing the volume of the bronchi and bronchioles leading to wheezing.
There is an ongoing discussion about VIW versus asthma. It can be thought of as preschool wheezing that does not reach a diagnosis of asthma.
Presentation
VIW vs. asthma
Although VIW and asthma present similarly, VIW tends to differ in the following ways:
- Wheezing is triggered only by viral infections
- Children are generally <3 years old
- There is no history of atopy
Management
Overview
The management of VIW is similar to that of acute asthma in children:
- 1st-line: short-acting beta-2 agonists (SABA, e.g. salbutamol)
- 2nd-line: leukotriene receptor antagonists (LTRA, e.g. montelukast) or inhaled corticosteroids (ICS, such as beclometasone), or both
