A putative link between pertussis and gastroesophageal reflux with high rates of pulmonary aspiration.

Abstract

<b>Introduction:</b> Pertussis is an infectious disease of the respiratory tract with a changing epidemiology. An increasing incidence has been found in the adult population with recurrent infections due to changes in the current vaccine. An increasing number of patients present with a chronic cough and atypical symptoms suggestive of the relatively acute onset of gastroesophageal reflux symptoms (GORD) with respiratory complications. <b>Methods:</b> We report an observational study of post-pertussis (n=103) compared to non-pertussis patients(n=105) associated with established GORD. Patients were assessed for laryngopharyngeal reflux events and aspiration of refluxate by a new technology scintigraphic aspiration study. <b>Results:</b> Both groups showed abnormal reflux events in association with high rates of laryngopharyngeal reflux (LPR)events, pulmonary aspiration and lung disease. High rates of hiatus hernia and clinical diagnosis of “atypical” asthma showed correlations with pulmonary aspiration. <b>Conclusion:</b> A high level of new onset LPR and lung aspiration has been shown in patients with chronic cough after recent pertussis infection by a novel scintigraphic technique with fused hybrid x-ray computed tomography (SPECT/CT).