- In young children with episodic breathlessness, wheeze, and cough, the most likely alternative diagnosis to asthma is viral-induced wheeze.
- Other causes of persistent symptoms of breathlessness, wheeze, or cough:
- Allergic bronchopulmonary aspergillosis, allergic alveolitis, hypersensitivity pneumonitis, polyarteritis nodosa.
- Cystic fibrosis, chronic lung disease, ciliary dyskinesia, developmental anomaly (vascular ring) and other malformations affecting airway calibre, bronchopulmonary dysplasia.
- Laryngeal disorder, laryngo-tracheomalacia, tracheo-oesophageal fistula.
- Gastro-oesophageal reflux disease with or without aspiration, swallowing problems with aspiration.
- Congestive heart failure, pulmonary thromboembolism, sarcoidosis.
- Tumour, lymphoma with superior vena cava obstruction, neuromuscular disorder, immune deficiency.
- Psychogenic cough.
- Other causes of acute onset of breathlessness:
- Inhaled foreign body.
- Viral-associated wheeze of infancy, bronchiolitis, pneumonia, croup, bronchitis, pertussis.
- Post-nasal drip.
- Post-infection syndrome (bronchiolitis obliterans).
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