Sounds of Pertussis

1
Sounds of Pertussis

• Clinical Case Definition of Pertussis
• A cough illness lasting greater than two weeks
• with one of the following
• Paroxysms of coughing
• Click icon to hear paroxysms
• Inspiratory whoop
• Click icon to hear whoop
• Post-tussive vomiting, without other apparent
  cause

2
Pertussis Clinical Features

• Incubation period
• 5-10 days (up to 21 days)
• Initial Catarrhal stage (1-2 weeks)
• Insidious onset with irritating cough that
  gradually becomes paroxysmal most contagious
  phase
• Organism can be recovered in large numbers from
  pharyngeal cultures
• Severity and duration of the disease can be
  reduced by antimicrobial treatment

3
Pertussis Clinical Features

• Paroxysmal Stage ( 1-2 months)
• Paroxysms-repeated violent cough each series of
  paroxysms has many coughs without intervening
  inhalation, whoop may follow
• Whoop- large inspiratory gasp (Infants under 6
  months, vaccinated children adolescents do not
  have typical whoop or cough paroxsyms)
• Also may see Cyanosis, Apnea, Posttussive
  emesis
• During the second stage, B. pertussis can rarely
  be recovered from culture (PCR offers increased
  sensitivty later in the illness, up to 3 weeks or
  more than culture
• Antimicrobial agents have no effect on the
  progress of the disease
• Convalsecent Stage (up to 6months)

4
Pertussis Complications

• Highest MM in infants lt6months of age and in
  under vaccinated pre-school aged children
• Pneumonia leading cause of death from Pertussis
• Seizures, encephalopathy ( hypoxemia and toxin
  induced)
• Subdural hematomas, hernias, rectal prolapse,
  pneumothorax, hypoglycemia, subconj. Hemorrhage,
  ulcerated frenulum, otitis media