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Pertussis encephalopathy in an adult: case report and review
1Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract:
A 39-year-old man developed paroxysmal cough, occasional vomiting after cough, and subconjunctival hemorrhage. His illness was complicated by episodes of seizure, with clonic movements of the arms and legs, brief loss of consciousness, and confusion. The episodes were triggered by mild, unremarkable coughing paroxysms. A diagnosis of pertussis was confirmed serologically by measurement of IgG, IgA, and IgM antibodies to pertussis toxin and filamentous hemagglutinin. Serologic studies confirmed the presence of Bordetella pertussis infection in the patient's 10-year-old daughter and suggested that his wife was infected as well. This case report illustrates the occurrence of typical pertussis with serious complications in an adult. Further research is required to determine the scope of this problem and the need for a program of adult immunization against pertussis.
Insights
Adults can develop severe pertussis (whooping cough) with complications like seizures. This case highlights the need for adult immunization programs to prevent Bordetella pertussis spread.
Area of Science:
- Infectious Diseases
- Immunology
- Neurology
Background:
- Pertussis, or whooping cough, is a highly contagious respiratory infection primarily affecting infants.
- Adult vaccination rates for pertussis have historically been low, leading to potential reservoirs of infection.
Observation:
- A 39-year-old male presented with severe paroxysmal cough, vomiting, subconjunctival hemorrhage, and seizures.
- Neurological complications, including seizures, were triggered by coughing fits.
- Serological testing confirmed Bordetella pertussis infection in the adult patient and his daughter.
Findings:
- The adult patient exhibited typical pertussis symptoms with significant neurological complications.
- Serological evidence indicated a household transmission of Bordetella pertussis.
- The case demonstrates pertussis can cause severe illness and complications in adults.
Implications:
- This case underscores the potential for severe pertussis in unvaccinated or under-vaccinated adults.
- It highlights the importance of considering pertussis in adult patients presenting with severe respiratory and neurological symptoms.
- Further research is needed to assess the burden of adult pertussis and the efficacy of adult immunization programs.