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Infección por tos ferina en adultos con tos persistente
S W Wright1, K M Edwards, M D Decker
1Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-4700, USA.
JAMA
|April 5, 1995
Resumen
La tos ferina es una causa frecuente de tos persistente en adultos. Las pruebas serológicas revelaron una tasa de infección del 21%, destacando su importancia en el diagnóstico diferencial.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Medicina de las vías respiratorias Medicina de las vías respiratorias
- Microbiología Clínica y Microbiología Clínica.
Sus antecedentes:
- La tos persistente en adultos es una presentación clínica común.
- La tos ferina por Bordetella (tos ferina) puede causar síntomas respiratorios prolongados en adultos.
- El diagnóstico preciso de la tos ferina en adultos a menudo es un desafío.
Objetivo del estudio:
- Para determinar la prevalencia de la infección por Bordetella pertussis en pacientes adultos que se presentan con tos persistente.
- Evaluar los métodos de diagnóstico de la tos ferina en esta población.
Principales métodos:
- Serie de casos prospectivos realizados en el departamento de emergencias de un hospital universitario urbano.
- Se incluyeron 75 pacientes adultos con tos que duró ≥2 semanas.
- Utilizó cultivos nasofaríngeos, pruebas directas de anticuerpos fluorescentes y títulos de anticuerpos séricos (toxina de tos ferina [PT] y hemaglutinina filamentosa [FHA]) para el diagnóstico.
Principales resultados:
- No se identificaron casos de cultivo positivo de B. pertussis.
- Los criterios serológicos indicaron la infección por tos ferina en el 21% de los pacientes (16/75).
- Los síntomas clínicos y la linfocitosis no diferenciaron confiablemente la tos ferina de otras causas de tos.
Conclusiones:
- La tos ferina es una causa significativa y común de tos persistente en adultos.
- Debe considerarse en el diagnóstico diferencial de la tos prolongada.
- Los métodos de diagnóstico estándar como el cultivo y las pruebas de DFA tienen una utilidad limitada; la serología es más valiosa.
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