whooping cough Flashcards
what is whooping cough?
highly infectious disease caused by the bacterium bordetella pertussis
name derived from characteristic whoops that occur in younger children relating to sharp inhalation of breath during bouts of paroxysmal cough
what is croup?
known as laryngotracheobronchitis
common infection of the laryngotrachea
who does croup normally affect?
children aged 6 months to 6 years of age
peak incidence at 2 years of age
how do children present with croup?
coryza and fever
followed by hoarseness (secondary to inflammation of the vocal cords)
barking cough (secondary to tracheal oedema and collapse)
stridor
variable degree of difficulty in breathing
symptoms often worse at night
what are the three phases of symptoms of whooping cough?
catarrhal phase lasting between one and two weeks
paroxysmal phase happens 1 week after catarrhal phase and lasts between 1-6 weeks
convalescent phase lasts up to 3 months
what symptoms occur in catarrhal phase?
difficult to distinguish from upper respiratory tract infections
nasal discharge
conjunctivitis
malaise
sore throat
low grade fever
dry unproductive cough
what is the symptoms of paroxysmal phase of whooping cough?
short expiratory burst followed by inspiratory gast causing the whoop sound
yield thick mucous plugs or wartery secretions, usually no other chest signs
may be severe enough to cause cyanosis nad frequently associated with post-tussive vomitting
how to diagnose whooping cough?
acute cough lasting longer than 14 days without another apparent cause
one or more of following features: paroxysmal cough, inspiratory whoop, post-tussive vomiting, undiagnosed apnoeic attacks in young infant
suspcious if person is not fully immunised or in contact with person who is confirmed os suspected of having whooping cough
when is hospital admission needed for whooping cough?
6 months of age or younger and acutely unwell
significant breathing difficulties (apnoea episodes, severe paroxysms or cyanosis)
signifiacnt complication (seizure or pneumonia)
how to manage whooping cough if hospital admission not needed?
prescribe antibiotic if onset of cough is within the previous 21 days
macrolide antibiotic recommended first line
prescribe clarithromycin for infants less than 1 month
azithromycin or clarithromycin for children aged 1 month or older and non pregnant adults
erythromycin for pregnant women
how to manage croup without hospital admission?
single dose of oral dexamethasone
