Diagnostic category Examples
Normal child (the hardest diagnosis!)
Recurrent viral colds Pertussis “Nursery School Syndrome” (see text)
Serious illness Will show regional variation; includes cystic fibrosis, bronchiectasis, interstitial lung disease, tuberculosis
An ‘asthma syndrome’
Episodic viral wheeze Multiple trigger wheeze
Minor mimics or exacerbators of symptoms
Allergic or infective rhinitis Gastro-oesophageal reflux
Over-anxious parents
Often first-time parents who do not appreciate the range of normality Find out if they have some concealed fear, e.g. a friend’s child died of leukaemia having had a non-specific presentation