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Whooping Cough(Pertusis)

  1. Cough of 100 days.
  2. Caused by Bordetella pertussis (G-ve organism)
  3. Pertussis like illness also caused by adenovirus.
    1. Bordetella parapertussis.
    2. Bordetella bronchisepticus.
    3. Chlamydia.
  4. Not a single toxin disease like diphtheria or tetanus.
  5. Pertussis toxin responsible for systemic manifestations.
  6. FHA (filamentous hemagglutinin responsible for attachment to mucosa.
  7. Transmitted by droplets.
  8. Occurs in children <4yrs in developing countries.
  9. Incubation period 7-14 daysQ.
  10. 3 clinical stages:
    1. catarrhal phase: lasts for 7-10 days
      1. Most infectious in this phaseQ.
      2. Presents as URI.
    2. Paroxysmal cough: lasts for 2-4 weeks.
      1. Paroxysms of cough with characteristic WhoopQ.
      2. Ulceration of frenulum of tongue commonly seen.
      3. Precipitated by cold air, food and liquids.
    3. Convalescent phase: 2-4 weeks. 
  11. Complications:
    1. Respiratory :  Pneumonia
      1. Bronchiectasis.                    
      2. Pneumothorax
      3. Subcutaneous emphysema            
      4. TB may flare up.          
      5. Otitis media.
    2. GIT manifestations:
      1. Hernias                              
      2. Rectal prolapse.
      3. Subconjunctival haemorrhage
      4. Severe malnutrition.
    3. Neurological :       
      1. Convulsions                
      2. Encephalopathy
      3. Intracranial haemorrhage.          
      4. Hemiplegia and paraplegia. 
      5. Ataxia aphasia , blindness present. 
  12. Diagnosis: TLC increased with absolute lymphocytosis(absolute lymphocyte count >10000).
     
    Inoculate Petri dish Bordet Gengou medium or Regan Course medium directly by child coughing into it. 
  13. Treatment:
    1. Infants <6months ……..hospitalize.
    2. antibiotics in catarrhal phase shorten duration in illness.
    3. Erythromycin is preferred antibioticQ.
    4. Septran can also be used
    5. Salsol nebulization for bouts of cough.




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