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The Respiratory SystemWhooping cough Synonyms : Pertussis Clinical features, Diagnosis, Management, Prognosis, Nutrition, Herbs,
Clinical features: < BACK TO TOP >
The
disease develops through three distinct stages.
The
first stage is a highly infectious upper
respiratory catarrh that begins insidiously and lasts about 1 week during
which conjunctivitis (lacrimation), rhinitis (runny nose, sneezing) and an
unproductive troublesome cough are present. Fever is rare.
The
distinctive paroxysmal stage follows
and is characterised by severe bouts of coughing.
The
number of such paroxysms in 24 hours varies from an occasional attack to 40 to
50 and they are more severe at night.
Each
paroxysm consists of a succession of short sharp coughs (5-15) ending in a
deep inspiration during which the characteristic
whoop may be heard.
It may
be absent in older children and in adults because the air passages are much
wider.
Coughing
is accompanied by cyanosis, sweating and exhaustion, and frequently copious
amounts if viscid sputum may be expelled.
The
last paroxysm of a series frequently ends with vomiting.
The
paroxysmal stage lasts from one to several weeks and is followed by the stage
of convalescence during which the cough becomes less frequent and the
sputum less tenacious. Complications:
Bronchopneumonia,
resorption atelectasis (mucous plug obstruction of a bronchiole),
bronchiectasis, conjunctival haemorrhage, haemorrhage in the brain, oedema of
the brain (probably due to hypoxia). Diagnosis: < BACK TO TOP >
It is
very difficult in the catarrhal stage when the disease is most infectious,
but it is easier in the paroxysmal stage when the whoop has developed.
Bordetella
pertussis can be isolated
from the posterior wall of the nasopharynx in 90% of cases.
Specific
fluorescent antibody testing of nasopharyngeal smears accurately diagnoses
pertussis but is not as sensitive as culture. Examination of the blood shows marked leukocytosis (15-20 x 109/L) with 70-80% lymphocytes (sometimes this lymphocytosis is not seen in mild cases). Management < BACK TO TOP >
Pertussis
is serious in children younger than 2 with the mortality rate of around 1-2%
(deaths are caused by complications).
Isolation
is necessary for at least 4 weeks from disease onset or until symptoms have
subsided.
Erythromycin
may reduce the severity of the infection if given during the catarrhal stage
(it is not very effective if given in paroxysmal stage); ampicillin
may be used for erythromycin-intolerant patients.
A cough suppressant may be helpful in controlling the severity of
paroxysms; oxygen may be administered if cyanosis develops.
Skilled
nursing to maintain nutrition, especially in infants and young children, is
necessary. Prevention:
A
vaccine is available in form of ‘triple
antigen?/i> together with diphtheria and tetanus (DTP) and is given at age
of 2, 4 and 6 months.
Acellular
pertussis vaccines cause less fever and fewer local and systemic reactions. Active immunisation can very rarely (one in over 300,000 doses) cause fits or neurological damage which has led to a decrease in the number of children who are immunised against the disease. Prognosis < BACK TO TOP >
Nutrition < BACK TO TOP > Nutrition that alleviate or prevent Whooping cough :- Herbs < BACK TO TOP > Herbs that alleviate or prevent Whooping cough :- (source : -) |
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