1 - Paeds - Resp - Chest infections - Pertussis Flashcards
cause? important feature? what happens bc of this?
bordetella pertussis
highly contagious
endemic disease, with epidemics every 3-4 years
what are the 3 phases
Catarrhal phase - 1 week of coryzal sx
paroxysmal phase 3-6 weeks
convalescent phase - sx gradually decrease, may persist for months
paroxysmal phase - develops characteristic what? when worse? can culminate in? what happens during?
characteristic paroxysmal/spasmodic cough followed by inspiratory whoop
often spasms worse at night
can culminate in vomiting
child goes red/blue in face, mucus flows from nose and mouth
what is different in infants? what can occur after vigorous coughing?
infants - whoop maybe absent, bu apnoea is a feature at this stage
epistaxis and subconjunctival heamorrhage can occur after coughing
3 compx ? when to admit + isolate?
pneumonia
convulsions
bronchiectasis
- all uncommon
infants/young kids suffereing severe spasms of cough/cyanotic attacks
when to worry about compx
sig mortality esp in infants and those who have no completed their primary vaccination schedule at 4 months
Ix - how to ID organism? what else to look for?
ID early by culture of per-nasal sab, PCR more sensitive
marked lymphocytosis on FBC >15x10^9
mgmt pertussis - what AB? downfall of it?
erythromycin eradicates organism but only reduces Sx if started in catarrhal phase
who may get similar cough? what to give them? what else?
siblings, parents, school contacts
give close contacts erythromycin prophylaxis, vaccinate unvaccinated infant contacts
what helps reduce risk and severity? doesn’t guarantee what? what happens to this?
immunisation reduces risk and severity if affected, no guarantee of protection
protection level declines steadily during childhood
parental advice?
sx will resolve, get prophylaxis/immunity for close contacts, explain the worrying Sx
