Bordetella pertussis - Revision history

Aidan: /* Complications */

2024-09-23T20:35:25Z

Complications

← Older revision		Revision as of 20:35, 23 September 2024
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	*Case-fatality rate of 1% in children under 6 months		*Case-fatality rate of 1% in children under 6 months
	*~~Pnuemonia~~ is the most common complication, either caused by the disease itself for by coinfection (especially RSV)		*Pneumonia is the most common complication, either caused by the disease itself for by coinfection (especially RSV)
	*Encephalopathy is a rare complication, usually in unimmunized children		*Encephalopathy is a rare complication, usually in unimmunized children
	**Begins weeks 2 to 4 after cough, with seizures and focal neurologic deficits		**Begins weeks 2 to 4 after cough, with seizures and focal neurologic deficits

Aidan at 16:40, 25 January 2022

2022-01-25T16:40:44Z

← Older revision		Revision as of 16:40, 25 January 2022
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	*None of the vaccines carry life-long immunity; even the immunity from the acellular pertussis vaccine wanes after 4-5 years		*None of the vaccines carry life-long immunity; even the immunity from the acellular pertussis vaccine wanes after 4-5 years

	{{DISPLAYTITLE:''~~Bordatella~~ pertussis''}}		{{DISPLAYTITLE:''Bordetella pertussis''}}
	[[Category:Gram-negative coccobacilli]]		[[Category:Gram-negative coccobacilli]]
	[[Category:Respiratory infections]]		[[Category:Respiratory infections]]

Aidan: Aidan moved page Bordatella pertussis to Bordetella pertussis without leaving a redirect

2022-01-25T16:40:32Z

Aidan moved page Bordatella pertussis to Bordetella pertussis without leaving a redirect

← Older revision	Revision as of 16:40, 25 January 2022
(No difference)

Aidan: /* Post-Exposure Prophylaxis */

2020-09-15T14:18:20Z

Post-Exposure Prophylaxis

← Older revision		Revision as of 14:18, 15 September 2020
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	*Consider prophylaxis of close contacts (face-to-face within 3 feet), third-trimester pregnancy, infants, and healthcare workers		*Consider prophylaxis of close contacts (face-to-face within 3 feet), third-trimester pregnancy, infants, and healthcare workers
			*Should be considered up to 21 days following last contact
	*Options include:		*Options include:
	**[[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days		**[[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days

Aidan: /* Infection Control */

2020-09-15T14:17:56Z

Infection Control

← Older revision		Revision as of 14:17, 15 September 2020
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	*Droplet precautions		*Droplet precautions
			*Duration
			**Treated: after 5 days of effective treatment
			**Untreated: after 3 weeks from onset of paroxysms
			*Communicable from onset of catarrhal stage to 3 weeks after onset of coughing or paroxysms

	=== Post-Exposure Prophylaxis ===		===Post-Exposure Prophylaxis===

	* Consider prophylaxis of close contacts (face-to-face within 3 feet), third-trimester pregnancy, infants, and healthcare workers		*Consider prophylaxis of close contacts (face-to-face within 3 feet), third-trimester pregnancy, infants, and healthcare workers
	* Options include:		*Options include:
	** [[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days		**[[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days
	** [[Erythromycin]] 500 mg qid for 7 to 14 days		**[[Erythromycin]] 500 mg qid for 7 to 14 days
	** [[Clarithromycin]] 500 mg bid for 7 days		**[[Clarithromycin]] 500 mg bid for 7 days

	===Immunization===		===Immunization===

Aidan at 13:15, 18 August 2020

2020-08-18T13:15:59Z

← Older revision		Revision as of 13:15, 18 August 2020
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	==Management==		==Management==

	*Treat within 21 days of symptom onset (except if <1 mo. old, ~~just~~ treat)		*Treat within 21 days of symptom onset (except if <1 mo. old, treat regardless of duration)
	*In children		*In children
	**[[Azithromycin]] 10 mg/kg on day 1 followed by 5 mg/kg/d for 4 days		**[[Azithromycin]] 10 mg/kg on day 1 followed by 5 mg/kg/d for 4 days
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	**[[Azithromycin]] 500mg followed by 250 mg daily for 4 more days		**[[Azithromycin]] 500mg followed by 250 mg daily for 4 more days
	**[[Erythomycin]] 500 mg qid for 7-14 days		**[[Erythomycin]] 500 mg qid for 7-14 days
⚫	**[[Clarithromycin]] 500 mg bid for 7 days
⚫	*Consider prophylaxis of close contacts, third-trimester pregnancy, infants, and healthcare workers
⚫	**[[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days
⚫	**[[Erythromycin]] 500 mg qid for 7 to 14 days
	**[[Clarithromycin]] 500 mg bid for 7 days		**[[Clarithromycin]] 500 mg bid for 7 days

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	*Droplet precautions		*Droplet precautions

			=== Post-Exposure Prophylaxis ===

		⚫	* Consider prophylaxis of close contacts (face-to-face within 3 feet), third-trimester pregnancy, infants, and healthcare workers
			* Options include:
		⚫	** [[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days
		⚫	** [[Erythromycin]] 500 mg qid for 7 to 14 days
		⚫	** [[Clarithromycin]] 500 mg bid for 7 days

	===Immunization===		===Immunization===
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	{{DISPLAYTITLE:''Bordatella pertussis''}}		{{DISPLAYTITLE:''Bordatella pertussis''}}
	[[Category:Gram-negative coccobacilli]]		[[Category:Gram-negative coccobacilli]]
			[[Category:Respiratory infections]]
			[[Category:Pediatrics]]

Aidan: /* Clinical Manifestations */

2020-08-18T13:13:10Z

Clinical Manifestations

← Older revision		Revision as of 13:13, 18 August 2020
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	*Three stages:		*Three stages:
	*#'''Catarrhal stage''', with rhinorrhea, nonpurulent conjuctivitis, occasional cough, and a low-grade fever; lasts 1 to 2 weeks.		*#'''Catarrhal stage''', with rhinorrhea, nonpurulent conjuctivitis, occasional cough, and a low-grade fever; lasts 1 to 2 weeks.
	*#'''Paroxysmal stage''', with fits of coughing and an inspiratory whoop; lasts 1 to 6 weeks. Occasionally associated with hyperinsulinemia and hypoglycemia in infants.		*#'''Paroxysmal stage''', with fits of coughing and an inspiratory whoop; lasts 1 to 6 weeks. May have post-tussive emesis. Occasionally associated with hyperinsulinemia and hypoglycemia in infants.
	*#'''Convalescent stage''', with the cough slowly resolving over 1 to 6 weeks, occasionally up to 8 weeks.		*#'''Convalescent stage''', with the cough slowly resolving over 1 to 6 weeks, occasionally up to 8 weeks.

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	*Post-tussive vomiting is suggestive of pertussis		*Post-tussive vomiting is suggestive of pertussis

	=== Carrier State ===		===Carrier State===

	*Transient nasopharyngeal carriage in immunized children		*Transient nasopharyngeal carriage in immunized children

	=== Complications ===		===Complications===

	*Case-fatality rate of 1% in children under 6 months		*Case-fatality rate of 1% in children under 6 months
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	*The paroxysms of coughing can also cause subconjunctival hemorrhages, syncope, and rib fractures		*The paroxysms of coughing can also cause subconjunctival hemorrhages, syncope, and rib fractures

	== Diagnosis ==		==Diagnosis==

	*Nasopharyngeal swab/aspirate culture		*Nasopharyngeal swab/aspirate culture
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	**Antigens including PT		**Antigens including PT

	== Management ==		==Management==

	*Treat within 21 days of symptom onset (except if <1 mo. old, just treat)		*Treat within 21 days of symptom onset (except if <1 mo. old, just treat)
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	**[[Clarithromycin]] 500 mg bid for 7 days		**[[Clarithromycin]] 500 mg bid for 7 days

	== Prevention ==		==Prevention==

	===Infection Control===		===Infection Control===

Aidan: /* Clinical Manifestations */

2020-08-05T13:59:42Z

Clinical Manifestations

← Older revision		Revision as of 13:59, 5 August 2020
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	*Presents with cough lasting 14 days or more, with paroxysms of coughing, an inspiratory whoop, and post-tussive vomiting		*Presents with cough lasting 14 days or more, with paroxysms of coughing, an inspiratory whoop, and post-tussive vomiting
	*Incubation period or 7 to 10 days on average (range 5 to 21 days)		*Incubation period of [[Usual incubation period::7 to 10 days]] on average (range [[Incubation period range::5 to 21 days]])

	===Young Children===		===Young Children===

Aidan at 23:35, 29 July 2020

2020-07-29T23:35:24Z

← Older revision		Revision as of 23:35, 29 July 2020
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	== Background ==		==Background==

	===Microbiology===		===Microbiology===
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	*Few systemic manifestations because it doesn't enter circulation		*Few systemic manifestations because it doesn't enter circulation

			==Clinical Manifestations==
	==Pertussis==

	===Presentation===

	*Presents with cough lasting 14 days or more, with paroxysms of coughing, an inspiratory whoop, and post-tussive vomiting		*Presents with cough lasting 14 days or more, with paroxysms of coughing, an inspiratory whoop, and post-tussive vomiting
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	*Post-tussive vomiting is suggestive of pertussis		*Post-tussive vomiting is suggestive of pertussis

	===~~Diagnosis~~===		=== Carrier State ===

		⚫	*Transient nasopharyngeal carriage in immunized children

			=== Complications ===

		⚫	*Case-fatality rate of 1% in children under 6 months
		⚫	*Pnuemonia is the most common complication, either caused by the disease itself for by coinfection (especially RSV)
		⚫	*Encephalopathy is a rare complication, usually in unimmunized children
		⚫	**Begins weeks 2 to 4 after cough, with seizures and focal neurologic deficits
		⚫	*Pulmonary hypertension
		⚫	*Pneumonia and urinary incontinence are common in older patients
		⚫	*The paroxysms of coughing can also cause subconjunctival hemorrhages, syncope, and rib fractures

			== Diagnosis ==

	*Nasopharyngeal swab/aspirate culture		*Nasopharyngeal swab/aspirate culture
Line 52:		Line 64:
	**Antigens including PT		**Antigens including PT

	===Management===		== Management ==

	*Treat within 21 days of symptom onset (except if <1 mo. old, just treat)		*Treat within 21 days of symptom onset (except if <1 mo. old, just treat)
	*In children		*In children
	**Azithromycin 10 mg/kg on day 1 followed by 5 mg/kg/d for 4 days		**[[Azithromycin]] 10 mg/kg on day 1 followed by 5 mg/kg/d for 4 days
	**Erythomycin 40-50 mg/kg/d divided qid for 7-14 days		**[[Erythomycin]] 40-50 mg/kg/d divided qid for 7-14 days
	**Clarithromycin 15 mg/kg/d divided bid for 7 days		**[[Clarithromycin]] 15 mg/kg/d divided bid for 7 days
	**Azithromycin for children <1 year		**[[Azithromycin]] for children <1 year
	*In infants <1 mo, azithromycin 10 mg/kg/d for 5 days		*In infants <1 mo, [[azithromycin]] 10 mg/kg/d for 5 days
	*In adults		*In adults
	**Azithromycin 500mg followed by 250 mg daily for 4 more days		**[[Azithromycin]] 500mg followed by 250 mg daily for 4 more days
	**Erythomycin 500 mg qid for 7-14 days		**[[Erythomycin]] 500 mg qid for 7-14 days
	**Clarithromycin 500 mg bid for 7 days		**[[Clarithromycin]] 500 mg bid for 7 days
	*Consider prophylaxis of close contacts, third-trimester pregnancy, infants, and healthcare workers		*Consider prophylaxis of close contacts, third-trimester pregnancy, infants, and healthcare workers
	**Azithromycin 500 mg for one day followed by 250 mg for 4 more days		**[[Azithromycin]] 500 mg for one day followed by 250 mg for 4 more days
	**Erythromycin 500 mg qid for 7 to 14 days		**[[Erythromycin]] 500 mg qid for 7 to 14 days
	**Clarithromycin 500 mg bid for 7 days		**[[Clarithromycin]] 500 mg bid for 7 days

	==~~=Complications=~~==		== Prevention ==

⚫	*Case-fatality rate of 1% in children under 6 months
⚫	*Pnuemonia is the most common complication, either caused by the disease itself for by coinfection (especially RSV)
⚫	*Encephalopathy is a rare complication, usually in unimmunized children
⚫	**Begins weeks 2 to 4 after cough, with seizures and focal neurologic deficits
⚫	*Pulmonary hypertension
⚫	*Pneumonia and urinary incontinence are common in older patients
⚫	*The paroxysms of coughing can also cause subconjunctival hemorrhages, syncope, and rib fractures

	===Infection Control===		===Infection Control===
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	*Droplet precautions		*Droplet precautions

	==~~Carrier State~~==		===Immunization===

⚫	*Transient nasopharyngeal carriage in immunized children

	==Vaccination==

	*Options include whole-cell (DTP) and acellular (DTaP or Tdap)		*Options include whole-cell (DTP) and acellular (DTaP or Tdap)

Aidan at 15:46, 29 July 2020

2020-07-29T15:46:50Z

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