COUGH AND WHEEZING
F. STANFORD MASSIE MD1
1 2855 Bremo Rd, Richmond, Virginia
An 8-year old boy complained of coughing, sputum production, and wheezing after exercise. Symptoms had been present for 18 months. There were occasional nasal symptoms of stuffiness and itchy nose with sneezing and spells of laryngotracheobronchitis with chest congestion; these occurred months apart. Symptoms improved on Dimetapp and an antibiotic. Sputum varied from one tablespoon to one cup and occurred shortly after reclining in the evening. The sputum was clear and colorless but contained bits of food. Recent direct laryngoscopy and allergy tests were negative. There was no past history of colic, eczema, recurrent colds, or otitis. Because of chronic "mucus production" the child was seen by a second pediatric allergist, who noted "a chronically ill-appearing child with rhonchi in the chest" on one examination and a clear chest a second time; there was no increased A-P diameter or overexpansion of the chest.