Pediatric Coughs: Pertussis
PERTUSSIS
Valeria Wu, MD
Presentation: Whooping cough ( can sound like “barking”, stridor, hoarseness), sore throat, malaise, dysphagia, and low-grade fever / bacterial: Corynebacterium diphtheria
Diagnosis: Clinical with isolation of bacteria by culture of a nasopharyngeal swab. Classic thick, grey pseudomembranes on tonsils/soft palate, marked edema of neck “bull neck”
Treatment: erythromycin (500 mg four times daily for 14 days), antitoxin for severe cases, respiratory support
Take note: Can cause other complications such as myocarditis and diaphragmatic paralysis from neuritis
References:
Freire G, Shefrin A, Zemek R. Wheezing in Infants and Children. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw-Hill; Accessed October 29, 2020.
Parikh RR, Huang CJ. Stridor and Drooling in Infants and Children. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw-Hill; Accessed October 29, 2020.