Postinfectious Cough: Clinical Presentation
The annual incidence rate still remains highest among infants < 1 year of age, and in the majority of such children adults are the source of infection. Bordetella parapertussis has been shown to cause a disease similar to whooping cough but of shorter duration, possibly because it does not produce the pertussis toxin (PT), the principle agent responsible for severe coughing. Immunization with standard pertussis vaccines has not provided protection from B parapertussis, while modest protection has been seen with the newer acellular vaccines. natural asthma inhalers
Pertussis infection can present in a variety of settings; it may be an important cause of cough in college students, in military personnel, in referrals to a pulmonary specialist,’ in patients seeking emergency department care, in those seen in the primary care setting, in health-care workers, and in the elderly. Unfortunately, pertussis is not considered in the differential diagnosis of chronic cough by many practitioners. However, in a Canadian multicenter prospective study, pertussis infection was confirmed in 19.9% of adolescents and adults who met the criteria for postinfectious cough. The classic case of pertussis has been well-described. After an incubation period of 1 to 3 weeks, a 2-week virus-like illness ensues, and during this catarrhal phase symptoms of conjunctivitis, rhinorrhea, fever, malaise, and, later, cough occur. Leukocytosis and lymphocytosis, which are thought to be typical of a pertussis infection, frequently are not seen. The next phase, the paroxysmal phase, is characterized by worsening cough, often with the characteristic whooping sound, which consists of a series of expiratory bursts followed by a sudden loud inspiratory sound. In children < 2 years of age, vomiting or apnea is more commonly seen than the typical whooping sound. Adults may complain of shortness of breath and a tingling sensation in the throat, and posttussive emesis is common.
Category: Respiratory Symptoms
Tags: Bordetella pertussis, pertussis infection, postinfectious cough, postviral cough