Asthmatic symptoms may be divided into two types: (1) bronchial asthma, which usually responds to the routine measures for symptomatic relief, including ephedrine or epinephrine, and (2) status asthmaticus, the more severe form or shock type, which is characterized by extreme exhaustion and severe dyspnea bordering on collapse.
In the case reported severe status asthmaticus was recurrent and was complicated by sinus infections, drug allergy, and dermatitis medicamentosa due to neoarsphenamine. The case illustrates the complicated management of recurrent attacks of asthmatic bronchitis and episodes of status asthmaticus requiring heroic measures for the control of symptoms. On several occasions it was doubtful whether the patient would recover from the attacks of status asthmaticus.
History. A housewife, aged 38, was first seen at the Clinic on March 18, 1940. In May and June for twenty years she had rose fever with sneezing and rhinorrhea. In 1939 her symptoms began in March during the tree hay fever season and were associated with wheezing. The following September she had several attacks of asthma, and a month later she began to have attacks of coughing and wheezing every night. Since the onset of the nocturnal attacks she had lost five pounds and had become irritable and nervous. During the winter months she had a chronic postnasal drip. She noted that damp weather made her symptoms worse.
Aspirin and phenacetin made her wheeze, and codeine was thought to cause trouble also. She suspected that ham, cabbage, and milk caused water brash and nausea.