Term
|
Definition
fastidious Gram-Neg aerobic coccobacillus, alone or in pairs;
- non-motile;
- incubation period of 7-10 days; |
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Term
| Classical Clinical Presentation of Pertussis |
|
Definition
Catarrhal Stage (1-2 wks)
- mild unproductive cough, mild coryza, fever is uncommon, cough gradually increases;
Paroxysmal Stage (2-6 wks):
- cough persists & increases in severity: paroxysms, inspiratory whoop;
- post-tussive emesis in children;
- cyanosis &/or apnea in infants;
Convalescent Stage (1-2 wks or longer):
- cough subsides, exertion or URI may "trigger" cough |
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Term
| Atypical Presentation in Infants |
|
Definition
Catarrhal stage: very short or absent;
Symptoms:
- feeding difficulty, tachypnea, cough
- appear well between coughing episodes
- Whoop is RARE
Hx of another pt w/ cough important for diagnosis; |
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Term
| Atypical Presentation in Vaccinated Children |
|
Definition
less severe;
- shorter duration of cough;
- decreased apnea;
- decreased cyanosis; |
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Term
| Atypical Presentation of Pertussis in Adolescents & Adults |
|
Definition
immunity from vaccines will have waned;
catarrhal stage may be absent;
paroxysmal phase symptoms are less severe & w/o typical features (no whoop) |
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|
Term
| Complications of Pertussis |
|
Definition
apnea;
pneumonia;
weight loss secondary to feeding difficulties & post-tussive emesis |
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Term
| Clinical Diagnosis of Pertussis |
|
Definition
Consider with a cough lasting more than 14 days & accompanied by 1 of following:
- paroxysms of coughing, inspiratory whoop, post-tussive emesis;
Lab confirmation:
- culture, PCR |
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Term
| Supportive Care in Tx of Pertussis |
|
Definition
may require hospitalization for close monitoring for apnea & for monitoring of fluid status;
Avoid triggers for paroxysms:
- cold temps
- exercise |
|
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Term
| Supportive Tx that is NOT effective in Tx of Pertussis |
|
Definition
bronchodilators;
corticosteroids;
antitussives |
|
|
Term
| Macrolides (erythromycin, clarithromycin, azithromycin) |
|
Definition
| 1st line in antibiotic therapy of pertussis |
|
|
Term
| sulfamethoxazole-trimethoprim (SMX/TMP) |
|
Definition
| antibiotic option for tx of pertussis in pts w/ C/I to macrolides or if unable to tolerate macrolides |
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Term
| Antibiotics NOT effective in Tx of Pertussis |
|
Definition
ampicillin;
amoxicillin;
ALL cephalosporins;
fluroquinolones;
tetracycline |
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Term
| Tx of Pertussis in Child <1 month old |
|
Definition
| azithromycin 10 mg/kg/day in a single dose x 5 days |
|
|
Term
| Tx of Pertussis in Child 1-5 months old |
|
Definition
| azithromycin 10 mg/kg/day in a single dose x 5 days |
|
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Term
| Tx of Pertussis in Infants (> 6 months old) and Children |
|
Definition
| azithromycin 10 mg/kg in a single dose x day 1, then 5 mg/kg/day (max of 500 mg) on days 2-5 |
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Term
| Tx of Pertussis in Adolescents & Adults |
|
Definition
| azithromycin 500 mg in a single dose on day 1, then 250 mg per day as a single dose on days 2-5 |
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Term
| Post-Exposure Prophylaxis |
|
Definition
give if within 21 days of onset of cough;
give to both immunized & non-immunized;
Target:
- household members, daycare workers & attendees, selected school settings;
Plan: FULL dose of Abx used in tx of pertussis --> azithromycin (most tolerated, shortest course) |
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Term
| Routine Childhood Vaccination w/ DTaP |
|
Definition
5 doses total - given at 2 mo, 4 mo, 6 mo, 15-18 mo, & 4-6 yrs;
Complete 1st 4 doses as primary immunity;
5th dose is a "booster" |
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|
Term
| "New" Routine Adolescent Vaccination w/ Tdap |
|
Definition
| 1 dose at 11-12 yr of age |
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Term
|
Definition
| 1 of every 10 year "tetanus shots (Td)" should be replaced w/ Tdap |
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