6½ year old girl referred by school nurse for chronic cough. During her entire childhood she has been considered very sensitive to infections, with long periods of coughing. Since school started 3 months ago, the problem has been accentuated. Her teacher considers her fretful and whiny, especially during gym classes, where she often interrupts activities with her coughing.

Physical examination

Underweight. Raised shoulders. Hyperinflation. Slightly prolonged expiration. Reduced breathing sounds, basally and bilaterally. Coughing after light exertion in the consulting room.

Suspected diagnosis

Asthma? Respiratory infection?

Diagnosis & follow-up

Laboratory results show positive ImmunoCAP® Phadiatop® and IgE antibodies (ImmunoCAP®) to cat, dog and grass pollen. A b-2-agonist was prescribed as inhalant spray and the child was taught to use it whenever necessary. As prophylactic treatment, inhalant steroids were prescribed. After removal of the family cat from the home and information to the teacher about warming up before exercise, the child's symptoms are now well under control.