成年人患有持续咳的百日咳感染
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
概括
百日咳是成年人持续咳的常见原因之一. 血清检测显示,感染率为21%,这凸显了其在差异诊断中的重要性.
科学领域:
- 传染性疾病 传染性疾病
- 呼吸系统医学 呼吸系统医学
- 临床微生物学 临床微生物学
背景情况:
- 成年人持续咳是一种常见的临床表现.
- 百日咳 Bordetella (百日咳) 可以导致长时间的呼吸道症状在成年人.
- 在成年人中准确诊断 pertussis 往往是具有挑战性的.
研究的目的:
- 为了确定 Bordetella pertussis 感染在患有持续咳的成年患者中的流行率.
- 评估这个人群中百日咳的诊断方法.
主要方法:
- 在城市大学医院急诊室进行的前景病例系列.
- 招募了75名患有持续≥2周咳的成年患者.
- 使用鼻培养物,直接光抗体测试,以及血清抗体标位 (咳毒素[PT]和丝状血凝素[FHA]) 进行诊断.
主要成果:
- 没有发现B. pertussis的培养阳性病例.
- 血清学标准表明,21%的患者 (16/75) 感染了 pertussis.
- 临床症状和淋巴细胞分裂不能可靠地区分 pertussis 和咳的其他原因.
结论:
- 百日咳是成年人持续咳的重要和常见原因之一.
- 在长期咳的差异诊断中应考虑.
- 像培养和DFA测试这样的标准诊断方法具有有限的实用性;血清学更有价值.
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