• N Beydon, I Menier, L Hovloet-Vermaut, B Delaisi, N Pinto da Costa, and M Lorrot.
• Unité fonctionnelle de pneumologie pédiatrique, AP-HP, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France. nicole.beydon@rdb.aphp.fr
• Arch Pediatr. 2009 Mar 1;16(3):294-8.

AbstractAn asthmatic girl was first hospitalized at age 2(9/12) years because of dyspnoea, lung consolidations and/or atelectasis, and rattling. Between ages 2(9/12) and 6(2/12) years, she required three hospitalizations in ICU out of nine hospitalizations for the same symptoms. Differential diagnosis of this difficult to treat asthma disclosed severe tracheomalacia and persistent asthma. Treatments given according to the clinical, radiological and functional findings failed to decrease frequency and severity of acute respiratory episodes. Eventually, positive pressure ventilation delivered at airway opening (via a mouthpiece) associated to active respiratory physiotherapy succeeded in removing atelectasis and quickly cured the five following acute episodes without any further hospitalization. This case report is about diagnosis procedure, intricate asthma and tracheomalacia, and open mind to unusual therapeutics that may disclose potential help.

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