Severe respiratory infections in early life, particularly lower respiratory tract infections, such as bronchiolitis and pneumonia, may increase the risk of subsequent wheezing and asthma.

Congenital pulmonary airway malformation (CPAM) is a rare developmental lung anomaly that may present in the neonatal period with respiratory distress, and its association with dextrocardia is exceptional, potentially leading to diagnostic challenges. We report the case of a 26-day-old male neonate, born at term, admitted for cyanosis and respiratory distress. Clinical examination revealed tachypnea (68 breaths per minute), oxygen desaturation (SpO₂ 65% in room air), and signs of respiratory distress, with cardiac auscultation suggesting right-sided heart sounds. Imaging studies demonstrated a cystic lesion of the left upper lobe consistent with congenital pulmonary airway malformation, associated with cardiac dextroposition due to mediastinal shift, rather than true dextrocardia. The patient received supportive care and broad-spectrum antibiotic therapy; however, the clinical course was marked by progressive respiratory deterioration complicated by severe pulmonary infection, ultimately resulting in death before surgical intervention could be undertaken. CPAM results from abnormal airway development, and it is associated with cardiac dextroposition due to mediastinal shift, rather than true dextrocardia. This case highlights the importance of considering CPAM in neonates presenting with respiratory distress and emphasizes the crucial role of imaging, particularly computed tomography, in establishing the diagnosis and guiding management.

In paediatric treatment, persistent wheeze in babies continues to pose significant challenges for identification and management. The forthcoming retrospective cohort study recently published in World Journal of Clinical Pediatrics, entitled "Understanding recurrent wheezing: A parent's Guide" by Kiatvitchukul et al offers essential insights by pinpointing independent factors linked to recurrence, such as age 12-24 months, preterm birth, allergic rhinitis, eosinophilia, and previous lower respiratory tract infections. The median time to recurrence of about 100 days is important since it shows that there is a good potential for quick treatment and comprehensive follow-up. This comment makes it clear how crucial it is to use this kind of proof in both community and clinical settings. By checking for clinical signs and chatting to their parents, you can find kids who are at high risk early on. This makes it easier to give them customized counselling, reduce their exposure to allergens, and start them on controller medicines when they need them. The study's results show that pediatricians, allergists, and carers need to work together to stop the same problems from happening again and cut down on hospital readmissions. By changing how they see the "100-day window" as an important time for monitoring and putting preventive measures into action, pediatricians can improve outcomes and give families more control over their child's respiratory health. We need more multicenter prospective research to learn more about the biological, environmental, and socioeconomic factors that lead to recurrence. This will help us turn these findings into standard approaches to care for people.

A previously healthy lady in her mid-30s presented to the medical emergency with recurrent episodes of flushing, rash, wheezing, chest tightness, palpitations, dyspnoea, and loss of consciousness. After five months of intensive medical investigations, she was referred to the gynaecological team, and a detailed clinical history made it clear that these episodes always occurred after unprotected penetrative sexual intercourse. The patient was thoroughly investigated with cardiological evaluation and imaging. Eventually, a semen allergy test was performed by injecting 1 cc of semen subcutaneously in the forearm, which pushed the patient into anaphylactic shock. The patient was treated with hydrocortisone, adrenaline, and an antihistamine. The patient recovered within 24 hours. The patient was diagnosed with a semen allergy. After the diagnosis, the patient was given an EpiPen and instructed to use condoms for sexual intercourse. Barrier contraception prevented any further episodes.