An 8-year-old girl is brought into the physician's office in mild respiratory distress. She has a history of allergies to cats and wool, and her parents state that she has recurrent episodes of upper respiratory tract infections. Physical examination shows expiratory wheezes, use of accessory respiratory muscles, and a hyperresonant chest to percussion. Analysis of arterial blood gases discloses respiratory alkalosis, and the peripheral eosinophil count is increased. What is the appropriate diagnosis?

Asthma. Asthma is a chronic lung disease caused by increased responsiveness of the airways to a variety of stimuli. Patients typically have paroxysms of wheezing, dyspnea, and cough. Acute episodes of asthma may alternate with asymptomatic periods or they may be superimposed on a background of chronic airway obstruction. The consensus hypothesis attributes bronchial hyperresponsiveness in asthma to an inflammatory reaction to diverse stimuli, either extrinsic (e.g., pollen) or intrinsic (e.g., exercise). Extrinsic asthma is typically a childhood disease, whereas intrinsic asthma usually begins in adults. The other choices do not lead to wheezing and eosinophilia.Diagnosis: Asthma