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This is a story of a nine year old girl who has been treated for asthma since she was 18 months old with out much improvement. She had the usual symptoms of asthma: chronic coughing, shortness of breath with exercise, and sputum production. Like some other asthmatics, she also had many episodes of recurrent lower lobe pneumonia. Her first pneumonia was at four years old. These pneumonias were diagnosed with chest x-ray and got better on antibiotics. In spite of all medications for asthma: bronchodilators, corticosteroids, and leukotriene inhibitors, her respiratory symptoms did not improve. She had been hospitalized several times for pneumonias. There was a asthma and allergy in the father. There was no household flooding, water damage, or overgrowth of molds. She has not traveled out of the country nor been exposed to birds, domestic pets, or farm animals. She was born premature at 31 weeks gestation and had respiratory distress that required intubation for two weeks. She also had CT scan of the chest which did not show any enlarged lymph nodes, bronchiectasis, or vascular malformation. There was no signs of abnormal placement of the heart (situs inversus) on the chest x-ray. A barium swallow was normal. Reference: PEDIATRIC NEWS, August 2002, page 2 and 47 Leo Leonidas, MD, FAAP, Assistant Clinical Professor in Pediatrics, Tufts University School of Medicine, Boston; Attending Pediatrician, Eastern Maine Medical Center, Bangor, Maine.
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