Wheezing after respiratory tract infection in athletes

Wheezing is a commonly encountered complaint by patients seen in sports medicine practice. Wheezes are a continuous musical sound heard best on expiration and can originate from one or more of several defined anatomical locations in the human airway. While common causes of wheezing include exercise-induced bronchoconstriction, postnasal drip, and asthma, wheezing also follows specific respiratory infections and can persist for months after the onset of symptoms. Abnormal lung physiology following pneumonia can persist for decades. These postinfectious pulmonary changes affect the ability of athletes to return to sports. In addition to history and physical examination, diagnosis may require pulmonary function testing and exercise challenge testing. The cornerstone to management is an accurate diagnosis and using lifestyle and pharmacologic intervention. Return to play should be gradual and allowed only after individuals demonstrate adequate pulmonary capacity to meet the demands of their sport. Providers also should be aware of governing body regulations regarding treatments and required therapeutic use exemptions.