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[Pertussis--an illness with typical clinical symptoms?]
U Heininger1, U Storr, M A Uberall
1Universitätsklinik mit Poliklinik für Kinder und Jugendliche, Universität Erlangen/Nürnberg.
Summary
Pertussis (whooping cough) can present unusually, even without typical coughs, especially in infants and immunocompromised individuals. Early microbiological diagnosis is crucial for identifying these atypical pertussis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pertussis incidence has increased in West Germany.
- Bacteriological diagnosis has broadened the understanding of B. pertussis infections.
- Typical pertussis symptoms may not always be present.
Observation:
- Three patients with atypical pertussis presentations are detailed.
- An infant experienced severe apnea without cough, diagnosed via nasopharyngeal swab.
- A premature infant with bronchopulmonary dysplasia presented with apnea and decompensation, diagnosed serologically.
Findings:
- Bordetella pertussis was isolated from patients with varied symptoms, including apnea and congestive heart failure.
- Diagnosis was confirmed through nasopharyngeal cultures and serologic methods.
- Adult contacts exhibited prolonged cough and clinical pertussis signs.
Implications:
- Microbiological investigation for B. pertussis is essential in respiratory infections.
- This aids in detecting atypical pertussis cases missed by initial clinical presentation.
- Broader diagnostic approaches improve pertussis case identification and management.