Pertussis (1B) Flashcards
What is pertussis?
NOTIFIABLE DISEASE
Whooping cough (aka pertussis) is a highly infectious disease caused by bacterium Bordetella pertussis which produces pertussis toxin.
What are the symptoms of pertussis?
- Catarrhal stage
Mild cough and coryza - Paroxysmal stage
Inspiratory whooping cough
+/- vomiting bouts, apnoea, cyanosis - Convalescent stage
Cough subsides over weeks/months
Who is at risk of pertussis?
no/incomplete immunisations
OR
close contact to infected person
What is required to confirm the diagnosis of pertussis
PCR nasal swab OR culture of nasopharyngeal aspirate OR serology
A 5 month old boy presents to the GP with his mum. She explains he had initially had a runny nose and a cough but the past day his cough has worsened and he has experienced vomiting afterwards. She explains that he is not upto date with his vaccinations. How would you manage this patient?
A) Discharge with safety netting
B) Complete immunisation
C) Discharge with clarithromycin
D) Hospital admission
E) Conservative
D) Hospital admission
Why?
If <6 months old OR cyanotic/apnoeic spells = hospital admission
A 5 year old boy presents to the GP with his mum. She explains he had initially had a runny nose and a cough which started 1 week ago but the past day his cough has worsened and he has experienced vomiting afterwards. She explains that he is not upto date with his vaccinations. How would you manage this patient?
A) Discharge with safety netting
B) Complete immunisation
C) Discharge with clarithromycin
D) Hospital admission
E) Conservative
C) Discharge with clarithromycin
AND STAY HOME FROM SCHOOL UNTIL 48HRS POST ANTIBIOTICS
A 5 year old boy presents to the GP with his mum. She explains he had initially had a runny nose and a cough which started 1 week ago but the past day his cough has worsened and he has experienced vomiting afterwards. She also noticed periods where his lips turned blue. She explains that he is not upto date with his vaccinations. How would you manage this patient?
A) Discharge with safety netting
B) Complete immunisation
C) Discharge with clarithromycin
D) Hospital admission
E) Conservative
D) Hospital admission
Why?
If <6 months old OR cyanotic/apnoeic spells = hospital admission
A mother brings her 4-week-old daughter to your GP. Her daughter has been unwell with coryzal symptoms for the past two weeks. She has now developed a cough which had caused concern. The mother describes coughing followed by periods in which the child stops breathing and turns blue. The child appears lethargic.
What is the most likely causative organism in this illness?
A) Bordetella pertussis
B) Parainfluenza virus
C) Staphylococcus aureus
D) Streptococcus pneumoniae
E) RSV
A) Bordetella pertussis
A 9-year-old girl is brought to see her GP by her mother with a 2 and a half week history of cough. Her mother says that she had a few days of coryzal symptoms around 3 weeks ago, shortly before the cough started. She says she coughs regularly that sometimes makes her vomit, and claims to have noticed a ‘whooping’ sound when she breathes in after a coughing fit. Her observations are all within normal limits.
Given the likely diagnosis, what is the appropriate treatment?
A) Admit to hospital for IV antibiotics
B) Advice only
C) Prescribe oral clarithromycin
D) Prescribe oral co-amoxiclav
E) Prescribe oral doxycycline
C) Prescribe oral clarithromycin
