Comparison of the clinical and laboratory characteristics of pertussis or viral lower respiratory tract infections

Abstract

Introduction: Whooping cough-like respiratory tract infections (WCLRTI) caused by factors other than the Bordetella pertussis are available. Clinical picture is difficult to differentiate between the B. pertussis and viral respiratory infections.

Methodology: Eighty-five patients with the diagnosis of WCLRTI were divided into 3 groups. Group 1 involved patients with pertussis shown by nasopharyngeal aspirate culture (NAC) and/or PCR. Group 2 consisted of patients who B. pertussis was not detected by NAC however, clinicians still evaluated them as potential patients of pertussis. Group 3 involved patients with the diagnosis of WCLRTI and those with VRTI detected by antigen detection/PCR.

Results: Patients with pertussis had longer duration of the symptoms prior to admission. Paroxysmal cough, whooping, vomiting after coughing, cyanosis, apnea, seizures and abdominal hernias were more common in patients with pertussis. Fever, wheezing, tachypnea, retraction, fine crackles and rhonchi were more common in Group 3. Chest radiographs of patients in Group 3 revealed more bronchopneumonic infiltration, increased aeration, and atelectasis. CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) were significantly higher in Group 3. Of the patients 43.6% had no pertussis vaccination due to being < 2 months in age and 29.4% had 1 dose.

Conclusions: Pertussis should be thought in differential diagnosis of children with complaints of episodes of paroxysmal cough, cough accompanied by gasping, vomiting after coughing; with leukocytosis, lymphocytosis and a normal chest X-ray. The majority of children with pertussis infection are those who have not had the opportunity for vaccination.