ABSTRACT
Our understanding of what constitutes asthma appears to have turned full circle in recent years, with a rediscovery of previously discarded conditions and diagnoses. With a greater understanding of the epidemiology, pathophysiology, and natural history of asthma has come a reassessment of its heterogeneous nature, and a recognition that many individuals wheeze only in association with viral infections. This is particularly relevant in pediatrics, where there is increasing evidence for a differentiation between classic asthma and viral-associated wheezing episodes. With this understanding has come a reappraisal of asthma therapies, and the realization that therapies that increase indices of pulmonary function may not necessarily be beneficial for virus-induced asthma attacks. Osler’s aphorism that “all that wheezes is not asthma” seems even more relevant today.
