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Inaccurate diagnosis in infants with pertussis. An eight-year experience

J Sotomayor, L B Weiner, J A McMillan

    American Journal of Diseases of Children (1960)
    |July 1, 1985
    PubMed

    Insights

    Diagnosing pertussis (whooping cough) in infants is often missed due to similar symptoms to other respiratory infections. Early suspicion and diagnosis are crucial for treatment and preventing spread.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Microbiology

    Background:

    • Pertussis (whooping cough) remains a significant concern in pediatric populations.
    • Early and accurate diagnosis is critical for effective treatment and public health interventions.

    Purpose of the Study:

    • To review cases of Bordetella pertussis infection identified via fluorescent antibody staining.
    • To compare clinical characteristics and diagnostic challenges of pertussis in hospitalized versus outpatient pediatric cases.
    • To identify key clinical indicators that aid in the timely diagnosis of pertussis.

    Main Methods:

    • Retrospective review of nasopharyngeal specimens positive for Bordetella pertussis via fluorescent antibody staining.
    • Analysis of patient demographics, immunization status, admission diagnoses, and clinical courses.
    • Comparison of initial differential diagnoses recorded by house officers.

    Main Results:

    • Pertussis was often misdiagnosed or not considered initially, with bronchiolitis being a common alternative diagnosis.
    • Severe coughing and frequent vomiting were identified as key clinical indicators for pertussis.
    • Younger age and lower immunization status correlated with more severe and prolonged illness.
    • Abnormal chest X-rays and elevated white blood cell counts were not consistently indicative of pertussis.

    Conclusions:

    • The diagnosis of pertussis is frequently delayed or missed due to overlapping symptoms with other infant respiratory infections.
    • Increased clinical suspicion in infants presenting with nonspecific respiratory symptoms is essential for prompt diagnosis and management.
    • Early diagnosis facilitates appropriate treatment and prevents further transmission of Bordetella pertussis.

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