Pertussis-like syndrome or pertussis: a delay diagnosis

  • Heda Melinda Nataprawira Department of Child Health, Faculty of Medicine, University of Padjadjaran/Hasan Sadikin Hospital, Bandung-Indonesia.
  • Finia Cahayasari Department of Child Health, Faculty of Medicine, University of Padjadjaran/Hasan Sadikin Hospital, Bandung-Indonesia.
  • Arifin Kashmir Department of Child Health, Faculty of Medicine, University of Padjadjaran/Hasan Sadikin Hospital, Bandung-Indonesia.
Keywords: Pertussis, pertussis-like syndrome, Bordet-Gengou agar, clarithromycin

Abstract

Background Recent reports of pertussis epidemiology from Asia,
Africa and South America have been limited, but the World
Health Organization estimates indicate that these regions have
the highest disease burden. Difficulty in estimating the prevalence
of pertussis is due to lack of access to diagnostic methods,
misdiagnoses, under-reporting, and different countries' reporting
criteria. A syndrome characterized by severe episodes of coughing
resembling whooping cough (pertussis) has also been defined as
pertussis-like syndrome.
Objective To report eleven cases of pertussis or pertussis-like
syndrome in the pediatric ward of Hasan Sadikin Hospital.
Methods This retrospective study was conducted by reviewing
medical records from 2008-2010. Characteristics of 11 pertussislike
syndrome patients were documented including age, gender,
history of pertussis immunization, clinical manifestations,
laboratory findings, initial diagnosis, treatment and clinical
response. Isolation of Bordetella pertussis using Bordet-Gengou
agar was also noted. Pertussis diagnoses were grouped based on
two classifications: probable and confirmed.
Results Eleven patients were diagnosed with pertussis-like
syndrome, including 5 boys and 6 girls. Most subjects were less
than 6 months of age. Only one subject had received previous
pertussis immunization. Dyspnea, paroxysmal cough, and fever
were the most common symptoms. All were initially diagnosed
to have had severe bacterial pneumonia, and later changed to
probable pertussis. Three subjects exhibited post-tussive vomiting
and cyanosis, while none had apneic symptoms. All B. pertussis
isolations yielded negative results. Ampicillin or cephalosporin
was initially administered. Patients receiving subsequent
clarithromycin showed good clinical responses.
Conclusion All infants were likely considered to have pertussis,
as most had no pertussis immunizations. However, B. pertussis
isolation was unsuccessful in all cases. As such, diagnoses could
not be confirmed. [Paediatr In don es. 2012;5 2: 28-31].

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Published
2012-03-30
How to Cite
1.
Nataprawira H, Cahayasari F, Kashmir A. Pertussis-like syndrome or pertussis: a delay diagnosis. PI [Internet]. 30Mar.2012 [cited 16Jun.2024];52(1):28-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/295
Section
Articles
Received 2016-08-21
Accepted 2016-08-21
Published 2012-03-30