Author: Julian Orenstein, M.D.
Educational Pearls
- Colorado has a high population of unvaccinated children, and is at increased risk for pertussis outbreaks.
- The causative organism is Bordetella pertussis. It causes causes respiratory epithelial necrosis leading to congestion of the bronchioles, leading to cough.
- The cough is unique - it is usually a series of expiratory coughs followed by one deep inspiration
- The clinical presentation is divided into 3 phases:
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- Catarrhal: cough and congestion with low-grade fever and coryza.
- Whooping: characteristic cough.
- Resolution: recovery with persistent cough.
- Infants may not get this presentation, but may get apnea and nonspecific cough.
- Tongue depressor can be used to elicit cough for diagnosis.
References: Tozzi AE, Pastore Celentano L, Ciofi degli Atti ML, Salmaso S. Diagnosis and management of pertussis. CMAJ : Canadian Medical Association Journal. 2005;172(4):509-515. doi:10.1503/cmaj.1040766.