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[Pertussis predictors in hospitalized infants with acute lower respiratory tract infection]

Laura Moreno, Patricia Montanaro, Elizabeth Bujedo

    Revista De La Facultad De Ciencias Medicas (Cordoba, Argentina)
    |September 27, 2013
    PubMed

    Insights

    Infants under six months with respiratory infections may present with similar symptoms. Apnea, cyanosis, and high lymphocyte counts can help differentiate pertussis (whooping cough) from RSV infections early.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Clinical Diagnostics

    Background:

    • Pertussis (whooping cough), caused by Bordetella pertussis (BP), is a re-emerging infectious disease.
    • Distinguishing pertussis from respiratory syncytial virus (RSV) infections in infants can be challenging due to overlapping symptoms.

    Purpose of the Study:

    • To compare clinical symptoms and diagnostic studies in infants hospitalized with acute respiratory infections (ARIs).
    • To identify early clinical prediction markers for differentiating BP from RSV in hospitalized infants.

    Main Methods:

    • An observational, analytical, case-crossover study compared infants under 6 months hospitalized with suspected ARI.
    • Bordetella pertussis (BP) and RSV infections were identified using PCR, culture, and immunofluorescence.
    • Bivariate analysis, including Odds Ratios (OR) with 95% Confidence Intervals (CI), was performed.

    Main Results:

    • Of 174 infants, 72 had BP and 102 had RSV.
    • Cyanosis (87% vs. 6%), apnea (38% vs. 3%), and vomiting (26% vs. 5%) were significantly more frequent in infants with BP.
    • Absolute lymphocyte count was significantly higher in infants with BP (9387 cells/mL vs. 5127 cells/mL), with 9000 cells/mL identified as a differentiator.

    Conclusions:

    • Apnea, cyanosis, and lymphocytosis are significant predictors for differentiating pertussis from RSV in infants under 6 months.
    • Early clinical recognition of these markers can aid in timely diagnosis and management of pertussis and RSV infections.
    Abstract

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