Pertussis - Revision history

Rossdonaldson1: /* Background */

2024-12-11T22:13:05Z

Background

← Revisión anterior		Revisión del 22:13 11 dic 2024
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	*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>		*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>
	*Bordetella pertussis, a [[gram-negative]] coccobacillus		*Bordetella pertussis, a [[gram-negative]] coccobacillus


	===Pathophysiology===		===Pathophysiology===

Rossdonaldson1: /* Differential Diagnosis */

2020-07-01T16:20:53Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Pediatric ~~fever~~ DDX}}		{{Pediatric SOB DDX}}

	==Evaluation==		==Evaluation==

ClaireLewis at 14:21, 13 October 2019

2019-10-13T14:21:01Z

← Revisión anterior		Revisión del 14:21 13 oct 2019
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	*One of the only vaccine preventable diseases that has increased in prevalence recently		*One of the only vaccine preventable diseases that has increased in prevalence recently
	*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>		*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>
	*Bordetella pertussis, a gram-negative coccobacillus		*Bordetella pertussis, a [[gram-negative]] coccobacillus


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	*Incubation period several days-3 weeks		*Incubation period several days-3 weeks
	*3 stages:		*3 stages:
	**Catarrhal phase: lasts 1-2 wks. Clinically indistinguishable from other ~~URIs~~; dry cough starts near the end. Greatest infectivity phase.		**Catarrhal phase: lasts 1-2 wks
	**Paroxysmal phase: lasts 2-4 weeks ~~=> fever~~ improves, cough worsens. Staccato cough + whoop (present in 1/3 kids), post-tussive emesis (often in adolescents, adults). Infants can present as apnea. Patients often appear well between coughing episodes.		***Clinically indistinguishable from other [[URI]]s; dry [[cough]] starts near the end
	***Petechiae, epistaxis, pneumothorax, and/or subconjunctival hemorrhage may occur due to high intrathoracic pressures during coughing.		***Greatest infectivity phase.
			**Paroxysmal phase: lasts 2-4 weeks
			***[[Fever]] improves, [[cough]] worsens
			***Staccato cough + whoop (present in 1/3 kids), post-tussive emesis (often in adolescents, adults)
			***Infants can present as apnea
			***Patients often appear well between coughing episodes.
			***[[Petechiae]], [[epistaxis]], [[pneumothorax]], and/or [[subconjunctival hemorrhage]] may occur due to high intrathoracic pressures during coughing.
	**Convalescent phase: lasts weeks-months; residual cough		**Convalescent phase: lasts weeks-months; residual cough

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	*[[Rib fracture]]		*[[Rib fracture]]
	*[[Pneumothorax]]		*[[Pneumothorax]]
	*Aspiration of gastric contents		*[[aspiration Pneumonia\|Aspiration]] of gastric contents
	*CNS complications		*CNS complications
	*Mucous plugs, obstructed airway		*Mucous plugs, obstructed airway
	*Secondary bacterial infection		*Secondary bacterial infection
	*Increased intrathoracic pressures		*Increased intrathoracic pressures
	**Rectal prolapse		**[[Rectal prolapse]]
	**Ruptured diaphragm		**Ruptured diaphragm
	**Hernia		**[[Hernia]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*WBC elevated in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL		*[[leukocytosis\|WBC elevated]] in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL
	*[[CXR]] with peribronchial thickening, atelectasis, and/or consolidation		*[[CXR]] with peribronchial thickening, atelectasis, and/or consolidation
	*Nasopharyngeal swab can identify it in 3-7 days; often neg in adults.		*Nasopharyngeal swab can identify it in 3-7 days; often neg in adults.

Rossdonaldson1: Text replacement - " wks " to " weeks "

2019-03-30T14:48:08Z

Text replacement - " wks " to " weeks "

← Revisión anterior		Revisión del 14:48 30 mar 2019
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	*Prophylaxis for all household exposures of known Pertussis		*Prophylaxis for all household exposures of known Pertussis
	*High risk people exposed to pertussis: infants, women in 3rd trimester of pregnancy, immunocompromised, severe [[asthma]], people with close contact to infants <1year, people who work in neonatal ICUs / maternity wards.		*High risk people exposed to pertussis: infants, women in 3rd trimester of pregnancy, immunocompromised, severe [[asthma]], people with close contact to infants <1year, people who work in neonatal ICUs / maternity wards.
	*Patients are considered considerably less infectious 3 ~~wks~~ after start of paroxysmal phase, or after 5 days of [[antibiotics]]		*Patients are considered considerably less infectious 3 weeks after start of paroxysmal phase, or after 5 days of [[antibiotics]]

	==Prevention==		==Prevention==

Kxl328: /* Post-Exposure Prophylaxis“ Pertussis Postexposure Antimicrobial Prophylaxis”. Centers for Disease Control and Prevention. http://www.cdc.gov/pertussis/outbreaks/pep.html. Aug 28, 2013 */

2018-10-12T03:55:55Z

Post-Exposure Prophylaxis“ Pertussis Postexposure Antimicrobial Prophylaxis”. Centers for Disease Control and Prevention. http://www.cdc.gov/pertussis/outbreaks/pep.html. Aug 28, 2013

← Revisión anterior		Revisión del 03:55 12 oct 2018
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	*Prophylaxis for all household exposures of known Pertussis		*Prophylaxis for all household exposures of known Pertussis
	*High risk people exposed to pertussis: infants, women in 3rd trimester of pregnancy, immunocompromised, severe [[asthma]], people with close contact to infants <1year, people who work in neonatal ICUs / maternity wards.		*High risk people exposed to pertussis: infants, women in 3rd trimester of pregnancy, immunocompromised, severe [[asthma]], people with close contact to infants <1year, people who work in neonatal ICUs / maternity wards.
	*Patients are considered infectious ~~for~~ 3 wks after start of paroxysmal phase, or after 5 days of [[antibiotics]]		*Patients are considered considerably less infectious 3 wks after start of paroxysmal phase, or after 5 days of [[antibiotics]]

	==Prevention==		==Prevention==

Neil.m.young: Text replacement - ", AND" to ", '''AND'''"

2017-05-31T12:24:11Z

Text replacement - ", AND" to ", '''AND'''"

← Revisión anterior		Revisión del 12:24 31 may 2017
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	==Background==		==Background==
	*“Whooping cough”. The “whoop” is caused on inspiration between coughs.<ref>Frumkin K. Pertussis and persistent cough: practical, clinical and epidemiologic issues. J Emerg Med. 2013 Apr;44(4):889-95.</ref>		*“Whooping cough”. The “whoop” is caused on inspiration between coughs.<ref>Frumkin K. Pertussis and persistent cough: practical, clinical and epidemiologic issues. J Emerg Med. 2013 Apr;44(4):889-95.</ref>
	*Most common in kids < 1yo, because they haven’t completed the whole vaccine series, AND adults, who have waning immunity.		*Most common in kids < 1yo, because they haven’t completed the whole vaccine series, '''AND''' adults, who have waning immunity.
	*One of the only vaccine preventable diseases that has increased in prevalence recently		*One of the only vaccine preventable diseases that has increased in prevalence recently
	*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>		*Up to 20% of adults with cough >2 weeks have serologic evidence of pertussis<ref>Trends in hospitalizations and resource utilization for pediatric pertussis. Hosp Pediatr. 2014 Sep;4(5):269-75</ref>

Rossdonaldson1: Text replacement - "CXR" to "CXR"

2016-09-09T12:12:48Z

Text replacement - "*CXR" to "*CXR"

← Revisión anterior		Revisión del 12:12 9 sep 2016
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	==Evaluation==		==Evaluation==
	*WBC elevated in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL		*WBC elevated in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL
	*CXR with peribronchial thickening, atelectasis, and/or consolidation		*[[CXR]] with peribronchial thickening, atelectasis, and/or consolidation
	*Nasopharyngeal swab can identify it in 3-7 days; often neg in adults.		*Nasopharyngeal swab can identify it in 3-7 days; often neg in adults.
	*Cough for >2 weeks, post tussive emesis, feeling well otherwise, treat them empirically. Especially if infant or pregnant people at home.		*Cough for >2 weeks, post tussive emesis, feeling well otherwise, treat them empirically. Especially if infant or pregnant people at home.

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T07:02:12Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 07:02 25 jul 2016
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	{{Pediatric fever DDX}}		{{Pediatric fever DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*WBC elevated in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL		*WBC elevated in infants (20-100) with large amount of lymphs (85%), adults and infants < 6 mo may be WNL
	*CXR with peribronchial thickening, atelectasis, and/or consolidation		*CXR with peribronchial thickening, atelectasis, and/or consolidation

Neil.m.young: Text replacement - "Pts " to "Patients "

2016-07-12T14:23:24Z

Text replacement - "Pts " to "Patients "

← Revisión anterior		Revisión del 14:23 12 jul 2016
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	*3 stages:		*3 stages:
	**Catarrhal phase: lasts 1-2 wks. Clinically indistinguishable from other URIs; dry cough starts near the end. Greatest infectivity phase.		**Catarrhal phase: lasts 1-2 wks. Clinically indistinguishable from other URIs; dry cough starts near the end. Greatest infectivity phase.
	**Paroxysmal phase: lasts 2-4 weeks => fever improves, cough worsens. Staccato cough + whoop (present in 1/3 kids), post-tussive emesis (often in adolescents, adults). Infants can present as apnea. ~~Pts~~ often appear well between coughing episodes.		**Paroxysmal phase: lasts 2-4 weeks => fever improves, cough worsens. Staccato cough + whoop (present in 1/3 kids), post-tussive emesis (often in adolescents, adults). Infants can present as apnea. Patients often appear well between coughing episodes.
	***Petechiae, epistaxis, pneumothorax, and/or subconjunctival hemorrhage may occur due to high intrathoracic pressures during coughing.		***Petechiae, epistaxis, pneumothorax, and/or subconjunctival hemorrhage may occur due to high intrathoracic pressures during coughing.
	**Convalescent phase: lasts weeks-months; residual cough		**Convalescent phase: lasts weeks-months; residual cough

Neil.m.young: Text replacement - "==Sources==" to "==References=="

2016-06-26T14:46:56Z

Text replacement - "==Sources==" to "==References=="

← Revisión anterior		Revisión del 14:46 26 jun 2016
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	*[[Vaccination schedule]]		*[[Vaccination schedule]]

	==~~Sources~~==		==References==
	<references/>		<references/>

	[[Category:ID]]		[[Category:ID]]
	[[Category:Pulmonary]]		[[Category:Pulmonary]]