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February 10th, 2021Hi there!
You’re looking at a short reference article from Explain Medicine (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.
Known exposure to pertussis
Pertussis, or whooping cough, is caused by the bacteria Bordetella pertussis. It is easily transmitted from person to person via airborne droplets. Contact with a known case of pertussis should raise suspicion for the disease in any symptomatic patient.
Stage 1: Catarrhal
Generally occurs 5 to 10 days after exposure and lasts 7 to 10 days. At this time there is coryza, low-grade fever, and a mild cough that gradually worsens.
Stage 2: Paroxysmal
This phase generally lasts 1 to 6 weeks. The classic triad of symptoms is paroxysms of cough, whooping on inspiration, and post-tussive vomiting. The paroxysms may be worse in older infants and young children, and are generally milder in adolescents and adults, especially if immunized. They are often absent in young infants.
This occurs due to the inability to expel mucus from tracheobronchial tree.
Stage 3: Convalescent
This phase lasts 2 to 6 weeks or longer. There is a gradual resolution of the paroxysmal cough. However, paroxysms may return with respiratory infections for several months.
Prolonged cough without paroxysms
The classic triad may be absent, especially in adolescents, adults, and immunized children.
Apnea
Infants may be without the classic symptoms and exhibit only apnea.
Neurologic complications
Seizures and encephalopathy may occur in infants. Encephalopathy is thought to be either due to lack of oxygenation or a direct effect of bacterial toxins.