Whooping cough

Question 1

Cause of whooping cough?

Answer 1

Bordatella pertussis (a gram negative bacteria)

Question 2

Presentation of whooping cough

Answer 2

Typically starts with mild coryzal symptoms - low fever

More severe coughing fits start after a week or more -

• Sudden intense coughing fits
• Loud inspiratory whoop when the coughing ends
• May cough so hard they faint, vomit or even develop a pneumothorax
• Infants with pertussis may present with apnoeas

Question 3

Diagnosis and investigations

Answer 3

FBC (WBC raised)

Diagnosis is largely clinical but…
Nasal swab with PCR testing can confirm the diagnosis

Question 4

Management

Answer 4

Largely supportive

May need admission if <6m, apnoeas, cyanosis etc…

Notify public health England

Macrolide antibiotics e.g. clarithromycin can be beneficial in vulnerable patients (or in early stages of the disease)

Close contacts given prophylactic antibiotics if in vulnerable group e.g. pregnant, unvax infants

Question 5

When does it resolve and complications?

Answer 5

Typically within 8w but can take several months

Complications include bronchiectasis