In Reply.—Bonforte has interpreted the adjective "unexpected" in the title of our article as an indication that the deaths of our 13 patients had "astonished" us, whereas "puzzled" would be closer to the mark. The reason for our puzzlement was not that death could befall these chronic asthmatics—after all, they had all the hallmarks of the high-risk patient—but that death had come suddenly and always in adolescent or preadolescent years. These were young people who had survived previous bouts of status asthmaticus dating back to their early childhood (with one exception). Many other high-risk chronic asthmatics treated similarly survived into adulthood. The question we put to ourselves was: Why these?
In addressing the appropriate questions raised regarding details of treatment of these patients, we can assure Bonforte that all patients (and their families) had been apprised of the seriousness of their illness and of the need for frequent follow-up