Most asthma exacerbations develop slowly and often have an identifiable cause. Occasionally a patient may develop a fulminant deterioration that can be life-threatening if not managed properly.


The condition usually affects young males.


Clinical features:

(1) The patient experiences a very rapid progression of pulmonary symptoms, with the duration of symptoms prior to presentation < 6 hours.

(2) The patient presents in extremis with cyanosis. The patient often requires intubation and mechanical ventilation.

(3) The patient may not be able to identify a triggering event (the attack occurs "out of the blue").

(4) The inflammatory cell infiltrate in the bronchial wall is typically rich in neutrophils.

(5) Recovery is relatively rapid if appropriate therapy is started.


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