持続的な咳を伴う成人における百日咳の感染
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
まとめ
百日咳は,大人の持続的な咳の原因である. 血清検査は21%の感染率を示し,差異診断におけるその重要性を強調した.
科学分野:
- 感染症 感染症は感染症です.
- 呼吸器医学とは
- クリニカル・マイクロバイオロジー
背景:
- 成人の持続的な咳は,一般的な臨床症状です.
- Bordetella pertussis (百日咳) は,成人において,呼吸器系の症状を長時間引き起こす可能性があります.
- 大人の pertussis の正確な診断は,しばしば困難です.
研究 の 目的:
- 絶え間ない咳を呈する成人の患者におけるボルデテラ・ペルツシス感染の有病率を決定する.
- この集団における百日咳の診断方法を評価する.
主な方法:
- 都市にある大学病院の救急治療室で実施された潜在的なケースシリーズ.
- 2週間以上続く咳を患った75人の成人の患者を登録した.
- 診断のため,鼻菌培養,直接光抗体検査,血清抗体タイター (咳毒素 [PT] と糸状血栓素 [FHA]) を利用した.
主要な成果:
- B. pertussisの培養に陽性な症例は特定されなかった.
- 血清学的基準は,患者の21%で pertussis 感染を示した (16/75).
- 臨床症状とリンパ細胞症は, pertussis を他の咳の原因から確実に区別することができなかった.
結論:
- 百日咳は,成人における慢性咳の重要かつ一般的な原因である.
- これは,長時間咳の差異診断において考慮されるべきである.
- 培養やDFA検査のような標準的な診断方法は,有用性が限られており,血清学はより価値があります.
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