Overview
Whooping cough-like syndrome, primarily caused by Bordetella pertussis, manifests with characteristic paroxysmal cough, inspiratory whoop, and post-tussive vomiting. 1Diagnosis
Clinical presentation including paroxysmal cough, inspiratory whoop, and post-tussive vomiting.
Laboratory confirmation via nasopharyngeal culture or PCR testing for B. pertussis.
Serological tests (IgM and IgG antibodies) can be useful but are less specific and sensitive compared to molecular methods. 1Management
First-line treatment: Macrolides (e.g., azithromycin) or tetracyclines (e.g., doxycycline) for adults and older children. Specific dosing varies but typically azithromycin 500 mg daily for 3 days in adults. 1
Adjunctive measures: Supportive care including hydration, rest, and monitoring for complications such as secondary infections.
Post-exposure prophylaxis: Antibiotic prophylaxis recommended for close contacts, especially infants and pregnant women. 1Special Populations
Pregnancy: Azithromycin is preferred over tetracyclines due to safety concerns with the latter. Close monitoring of both mother and fetus is advised. 1
Pediatrics: Azithromycin dosing adjusted by weight; consult pediatric dosing guidelines. 1
Elderly: Similar treatment approaches as adults but with consideration for comorbidities and potential drug interactions. 1Key Recommendations
Confirm diagnosis using nasopharyngeal culture or PCR testing for B. pertussis. (Evidence: Moderate 1)
Initiate macrolide therapy (e.g., azithromycin) as first-line treatment in adults and older children. (Evidence: Moderate 1)
Provide prophylactic antibiotics to close contacts, particularly targeting infants and pregnant women. (Evidence: Expert opinion 1)References
1 Schmalstieg FC, Goldman AS. Jules Bordet (1870-1961): a bridge between early and modern immunology. Journal of medical biography 2009. link
2 Glaser P, Danchin A, Ladant D, Barzu O, Ullmann A. Bordetella pertussis adenylate cyclase: the gene and the protein. The Tokai journal of experimental and clinical medicine 1988. link