Acute asthma exacerbation in adults

Case history

A 27-year-old woman with a history of asthma and taking medium dose ICS-LABA (inhaled corticosteroid-long acting beta agonist) presents to the emergency department with progressive worsening of shortness of breath, wheezing, and cough over 3 days. She reports prior exposure to a person who had a runny nose and a hacking cough. She did not receive significant relief from her reliever inhaler, with worsening symptoms, despite increased use. She has been taking her asthma medications regularly, which consist of an inhaled corticosteroid and a leukotriene receptor antagonist for maintenance therapy and salbutamol as reliever therapy. Her cough is disrupting her sleep pattern and as a consequence she is experiencing daytime somnolence, which is affecting her job performance.