a 15 year old boy presented with the prolonged cough and wheezing attack whch had

a 15 year old boy presented with the prolonged cough and wheezing attack whch had come on suddenly 36h earlier histroy he had experienced several episodes of wheezy bronchitis as a childd and eczema as an infant his father suffered from hay fever but there was no family history of asthma OE he was tired and unwell with a rapid respiratory rate and tachycardia (140\min)there were bilateral expiratory wheezes on chest auscultation investigations showed a normal heamoglobin but a raised white cell countx(power 9/l) a chest X ray was normal but lung funtion test showed reversibe airways obstruction need the provisional diagnosis and treatment

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