Bacteria

Question 1

Describe pertussis

Answer 1

Caused by bordetella pertussis
Pertusis has three clinical phases
1) catarrhal or prodomal phase :
-begins after an incubation period of approx 7-10 days and last approx 1-2 weeks.
-infectivity is greatest during this phase when the disease is clinically indistinguishable from other upper resp tract infections
-signs and symptoms include rhinorrhoea low grade fever malaise and conjunctival injection
2) paroxysmal phase begins as fever subsides
-cough increases and last 1-6 weeks
-paroxysms of staccato coughing occur and average of 15 times per day and are followed by a sudden forceful inhalation that produces the characteristic whoop - whoop is rare in infants who ay present with apnoeic episodes
-during the paroxysms the patient may exhibit cyanosis diaphoresis tongue protrusion salivation and lacrimation
-post ptussive vomiting and syncope are frequent
3) Convalescent phase
-residual cough may alst several months

Question 2

List complications of pertusis

Answer 2

1) Periorbital oedema
2) subconjunctival haemorrhage
3) petechiae
4) epistaxis
5) haemoptysis
6) subcut emphysema
7) pneumothorax
8) pneumoediastinum
9) diaphragm rupture
10) seizures and encphalopathy

Question 3

Discuss management of pertusis

Answer 3

Treatment is supportive and includes o2 frequent suctioning appropriate hydration parenteral nutrition as needed and avoidance of respiratory irritants.

Patient with pneumonia, hypoxia or CNS complications should be admitted

ABs do not significantly reduce the severity or duration of illness at any phase. The goal of antibiotic therapy is to decrease infectivity and carriage.
Azithromycin 10mg/kg or clarithromycin 15mg/kg