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Asthma

Perfume trigger asthma

11/12/2008

Question:

My daughter has had multiple asthma attacks each week at school due to perfume being sprayed in the hallways. She has now developed pneumonia. Could this be from having so many asthma attacks? She has had to be given predisone on at least three separate occasions in last two months, and 160 mg Symbacort and 4 breathing treatments a day.

Answer:

Asthma itself does not lead to pneumonia. The mucus plugging of airways that can occur during an asthma flare sometimes cause changes on an x-ray that look very similar to pneumonia, however.   Often, especially if the patient has a fever, physicians will error on the side of prescribing antibiotics (in addition to medication for the asthma symptoms) when this type of x-ray finding is seen.

The severity of your daughter's reaction to perfume is a little surprising given the controller medications you describe.  Further evaluation regarding the "baseline" (away from perfume) state of her asthma control would be important.  Also, consideration of other reactions which look like asthma - such as vocal cord dysfunction episodes - could be helpful.  Make sure her asthma specialist knows about these episodes; if she does not have one, I recommend consulting with a pediatric pulmonologist.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University