Pertussis infection in adults with persistent cough

Area of Science:

• Infectious Diseases
• Respiratory Medicine
• Clinical Microbiology

Background:

• Persistent cough in adults is a common clinical presentation.
• Bordetella pertussis (whooping cough) can cause prolonged respiratory symptoms in adults.
• Accurate diagnosis of pertussis in adults is often challenging.

Purpose of the Study:

• To determine the prevalence of Bordetella pertussis infection in adult patients presenting with persistent cough.
• To evaluate diagnostic methods for pertussis in this population.

Main Methods:

• Prospective case series conducted in an urban university hospital emergency department.
• Enrolled 75 adult patients with cough lasting ≥2 weeks.
• Utilized nasopharyngeal culture, direct fluorescent antibody testing, and serum antibody titers (pertussis toxin [PT] and filamentous hemagglutinin [FHA]) for diagnosis.

Main Results:

• No culture-positive cases of B. pertussis were identified.
• Serological criteria indicated pertussis infection in 21% of patients (16/75).
• Clinical symptoms and lymphocytosis did not reliably differentiate pertussis from other causes of cough.

Conclusions:

• Pertussis is a significant and common cause of persistent cough in adults.
• It should be considered in the differential diagnosis of prolonged cough.
• Standard diagnostic methods like culture and DFA testing have limited utility; serology is more valuable.