Abstract
In typical pertussis in young infants, the child will appear deceptively well; he or she will have coryza, sneezing, and a mild cough. There is no fever. This progresses to gagging, gasping, eye bulging, bradycardia, cyanosis, and vomiting. There is leukocytosis with lymphocytosis and apneic episodes. Deaths relate to leukocytosis, pulmonary hypertension, and pneumonia. The source of pertussis in young infants is most often a family member with cough illness that is not recognized as pertussis. Diagnosis is based on culture/polymerase chain reaction and leukocytosis with lymphocytosis. Treatment depends on macrolide antibiotic therapy and intubation, with assisted ventilation and oxygen. Prevention is based on prophylactic macrolide treatment, immunization starting at 6 weeks of age, and immunization of all pregnant women in the second or third trimester.
Highlights
In typical pertussis in young infants, the child will appear deceptively well; he or she will have coryza, sneezing, and a mild cough
Diagnosis is based on culture/ polymerase chain reaction and leukocytosis with lymphocytosis
Prevention is based on prophylactic macrolide treatment, immunization starting at 6 weeks of age, and immunization of all pregnant women in the second or third trimester
Summary
Pertussis; Bordetella pertussis; Tdap; DTaP; leukocytosis with lymphocytosis. Bordetella pertussis can cause severe disease and death but the illness is noninflammatory in nature, except when there is a concomitant or secondary bacterial or viral infection. Pertussis in young infants is frequently severe, and deaths are common [3, 5,6,7,8,9]. The bacterial cause of pertussis, B. pertussis, was isolated in the laboratory in 1906 [10]. This led the way for development of vaccines and their subsequent routine use in the 1940s and 1950s [11,12,13,14].
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