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Clinical and Laboratory Features of Pertussis in Hospitalized Infants with Confirmed Versus Probable Pertussis Cases
BACKGROUND: The clinical presentations of pertussis infection have considerable variation. Many infections and illnesses can cause prolonged repetitive paroxysmal cough that could be confused with Bordetella pertussis infection. AIM: This retrospective study was designed to compare the clinico-labor...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250990/ https://www.ncbi.nlm.nih.gov/pubmed/25506485 http://dx.doi.org/10.4103/2141-9248.144911 |
Sumario: | BACKGROUND: The clinical presentations of pertussis infection have considerable variation. Many infections and illnesses can cause prolonged repetitive paroxysmal cough that could be confused with Bordetella pertussis infection. AIM: This retrospective study was designed to compare the clinico-laboratory findings between two groups of hospitalized infants with confirmed, and those who have clinical pertussis disease; to identify the possible additional diagnostic clues “for the diagnosis of confirmed pertussis disease”. SUBJECTS AND METHODS: The study population consisted of infants ≤12 months of age with clinical diagnosis of pertussis that fulfilled the World Health Organization definition for pertussis or those diagnosed by physicians. Clinico-laboratory findings were compared between two groups of patients (confirmed vs. clinical cases). RESULTS: From a total of 118 infants admitted with a clinical diagnosis of pertussis, 16% (19/118) were confirmed by laboratory to have confirmed pertussis. Twelve of 19 (63%) and 71.99% of confirmed and clinical cases were younger than 6 months of age, respectively. For most patients, the duration of symptoms before hospitalization was <14 days. There were no significant differences between two groups of patients for paroxysmal cough and facial discoloration. However, whoop and apnea were more common among confirmed pertussis cases: P = 0.01, and P = 0.02, respectively. Leukocytosis (≥16,000/ml) (P = 0.01) and lymphocytosis (≥11,000) (P = 0.02) were reported significantly more frequently in confirmed pertussis cases. CONCLUSION: Given the unavailability of a highly sensitive diagnostic test, in every afebrile patient with paroxysmal cough lasting for ≥7 days associated with whoop and/or apnea, particularly if accompanied by leukocytosis/lymphocytosis, pertussis disease should be considered. In this situation, prompt administration of empiric treatment for cases, and providing control measures to prevent infection transmission to contacts are recommended. |
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