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Infant With Whooping Cough (Pertussis)

Discussion in 'Multimedia' started by fshadi81, Aug 30, 2019.

  1. fshadi81

    fshadi81 Active member

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    Pertussis
    Pertussis (whooping cough) is a respiratory tract infection characterized by a paroxysmal cough. The most common causative organism is Bordetella pertussis (see the image below), though Bordetella parapertussis has also been associated with this condition in humans. Pertussis remains a significant cause of morbidity and mortality in infants younger than 2 years.

    Signs and symptoms
    Pertussis is a 6-week disease divided into catarrhal, paroxysmal, and convalescent stages, each lasting 1-2 weeks.

    Stage 1 – Catarrhal phase
    • Nasal congestion
    • Rhinorrhea
    • Sneezing
    • Low-grade fever
    • Tearing
    • Conjunctival suffusion
    Stage 2 – Paroxysmal phase
    • Paroxysms of intense coughing lasting up to several minutes, occasionally followed by a loud whoop
    • Posttussive vomiting and turning red with coughing
    Stage 3 – Convalescent stage
    • Chronic cough, which may last for weeks
    Diagnosis
    The diagnosis of pertussis is made by isolation of B pertussis in culture. A polymerase chain reaction (PCR) test can also be performed.
    • The culture specimen should be obtained during the first 2 weeks of cough by using deep nasopharyngeal aspiration
    • For PCR testing, nasopharyngeal specimens should be taken at 0-3 weeks following cough onset
    • The CDC recommends a combination of culture and PCR assay if a patient has a cough lasting longer than 3 weeks
    • Early serial monitoring of white blood cell (WBC) counts is warranted
    Management
    Goals of treatment
    • Limit the number of paroxysms
    • Observe the severity of cough and provide assistance when necessary
    • Maximize nutrition, rest, and recovery
    Pharmacologic therapy
    • Antimicrobial agents and antibiotics can hasten the eradication of B pertussis and help prevent spread
    • Erythromycin, clarithromycin, and azithromycin are the preferred agents for patients aged 1 month or older
    Immunization

    Prevention through immunization remains the best defense in the fight against pertussis. CDC recommendations for vaccination are as follows:
    • DTaP vaccine: Recommended at the ages of 2, 4, 6, and 15-18 months and at age 4-6 years; it is not recommended for children aged 7 years or older.
    • Tdap vaccine: Recommended for children aged 7-10 years who are not fully vaccinated; as a single dose for adolescents 11-18 years of age; for any adult 19 years of age or older; and for pregnant woman regardless of vaccination history, including repeat vaccinations in subsequent pregnancies.
     

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    Last edited: Sep 2, 2019

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