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Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report

BACKGROUND: Pertussis is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis, characterized by paroxysms of severe coughing, and predominantly affects children. We report the first case of multiple fractures in the ribs, lumbar spine, and sacrum associated with sever...

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Autores principales: Wang, Jingqiao, Gao, Junxiang, Fan, Hongwei, Guo, Haonan, Yin, Zundong, Dong, Mei, Huang, Xiaoming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080936/
https://www.ncbi.nlm.nih.gov/pubmed/37024849
http://dx.doi.org/10.1186/s12879-023-08189-w
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author Wang, Jingqiao
Gao, Junxiang
Fan, Hongwei
Guo, Haonan
Yin, Zundong
Dong, Mei
Huang, Xiaoming
author_facet Wang, Jingqiao
Gao, Junxiang
Fan, Hongwei
Guo, Haonan
Yin, Zundong
Dong, Mei
Huang, Xiaoming
author_sort Wang, Jingqiao
collection PubMed
description BACKGROUND: Pertussis is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis, characterized by paroxysms of severe coughing, and predominantly affects children. We report the first case of multiple fractures in the ribs, lumbar spine, and sacrum associated with severe coughing caused by Bordetella pertussis infection in an adult. CASE PRESENTATION: A 49-year-old female presented with acute-onset chest wall pain for 3 weeks. Imaging results revealed multiple fractures in the ribs and vertebrae, as well as bilateral pleural effusion, pericardial effusion, right pneumothorax, and enlargement of the left parapharyngeal and subclavian lymph nodes. The patient’s bone density scan, autoimmune antibodies, bone marrow biopsy, and sacral bone biopsy all came back normal. Imaging test results found no evidence of solid tumors or active TB infection. The patient later recalled having violent coughing prior to the onset of chest pain and several family members having similar symptoms. Her blood sample was sent to the CDC, revealing Bordetella pertussis toxin (PT) IgG titer of 110.68 IU/mL. The patient was diagnosed with pertussis and multiple stress fractures from violent coughing. Symptomatic treatments were administered, and the patient’s symptoms improved. The patient was followed up 8 weeks later, she reported no more coughing or chest pain. CONCLUSIONS: Pertussis is not just a pediatric disease, but diagnosis in adults is challenging as patients may present with a myriad of confusing symptoms, such as multiple stress fractures due to violent coughing. Medical and epidemiological histories are key to reaching the correct diagnosis, which is essential for appropriate treatments to avoid further complications. Adult immunization should be suggested both for the protection of the adult population and to prevent transmission to children.
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spelling pubmed-100809362023-04-08 Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report Wang, Jingqiao Gao, Junxiang Fan, Hongwei Guo, Haonan Yin, Zundong Dong, Mei Huang, Xiaoming BMC Infect Dis Case Report BACKGROUND: Pertussis is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis, characterized by paroxysms of severe coughing, and predominantly affects children. We report the first case of multiple fractures in the ribs, lumbar spine, and sacrum associated with severe coughing caused by Bordetella pertussis infection in an adult. CASE PRESENTATION: A 49-year-old female presented with acute-onset chest wall pain for 3 weeks. Imaging results revealed multiple fractures in the ribs and vertebrae, as well as bilateral pleural effusion, pericardial effusion, right pneumothorax, and enlargement of the left parapharyngeal and subclavian lymph nodes. The patient’s bone density scan, autoimmune antibodies, bone marrow biopsy, and sacral bone biopsy all came back normal. Imaging test results found no evidence of solid tumors or active TB infection. The patient later recalled having violent coughing prior to the onset of chest pain and several family members having similar symptoms. Her blood sample was sent to the CDC, revealing Bordetella pertussis toxin (PT) IgG titer of 110.68 IU/mL. The patient was diagnosed with pertussis and multiple stress fractures from violent coughing. Symptomatic treatments were administered, and the patient’s symptoms improved. The patient was followed up 8 weeks later, she reported no more coughing or chest pain. CONCLUSIONS: Pertussis is not just a pediatric disease, but diagnosis in adults is challenging as patients may present with a myriad of confusing symptoms, such as multiple stress fractures due to violent coughing. Medical and epidemiological histories are key to reaching the correct diagnosis, which is essential for appropriate treatments to avoid further complications. Adult immunization should be suggested both for the protection of the adult population and to prevent transmission to children. BioMed Central 2023-04-06 /pmc/articles/PMC10080936/ /pubmed/37024849 http://dx.doi.org/10.1186/s12879-023-08189-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Wang, Jingqiao
Gao, Junxiang
Fan, Hongwei
Guo, Haonan
Yin, Zundong
Dong, Mei
Huang, Xiaoming
Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title_full Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title_fullStr Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title_full_unstemmed Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title_short Multiple rib and vertebral fractures associated with Bordetella pertussis infection: a case report
title_sort multiple rib and vertebral fractures associated with bordetella pertussis infection: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080936/
https://www.ncbi.nlm.nih.gov/pubmed/37024849
http://dx.doi.org/10.1186/s12879-023-08189-w
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