Paediatrica Indonesiana (Mar 2012)

Pertussis-like syndrome or pertussis: a delay diagnosis

  • Heda Melinda Nataprawira,
  • Finia Cahayasari,
  • Arifin Kashmir

DOI
https://doi.org/10.14238/pi52.1.2012.28-31
Journal volume & issue
Vol. 52, no. 1
pp. 28 – 31

Abstract

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Background Recent reports of pertussis epidemiology from Asia, Africa and South America have been limited, but the World Health Organization estimates indicate that these regions have the highest disease burden. Difficulty in estimating the prevalence of pertussis is due to lack of access to diagnostic methods, misdiagnoses, under-reporting, and different countries' reporting criteria. A syndrome characterized by severe episodes of coughing resembling whooping cough (pertussis) has also been defined as pertussis-like syndrome. Objective To report eleven cases of pertussis or pertussis-like syndrome in the pediatric ward of Hasan Sadikin Hospital. Methods This retrospective study was conducted by reviewing medical records from 2008-2010. Characteristics of 11 pertussislike syndrome patients were documented including age, gender, history of pertussis immunization, clinical manifestations, laboratory findings, initial diagnosis, treatment and clinical response. Isolation of Bordetella pertussis using Bordet-Gengou agar was also noted. Pertussis diagnoses were grouped based on two classifications: probable and confirmed. Results Eleven patients were diagnosed with pertussis-like syndrome, including 5 boys and 6 girls. Most subjects were less than 6 months of age. Only one subject had received previous pertussis immunization. Dyspnea, paroxysmal cough, and fever were the most common symptoms. All were initially diagnosed to have had severe bacterial pneumonia, and later changed to probable pertussis. Three subjects exhibited post-tussive vomiting and cyanosis, while none had apneic symptoms. All B. pertussis isolations yielded negative results. Ampicillin or cephalosporin was initially administered. Patients receiving subsequent clarithromycin showed good clinical responses. Conclusion All infants were likely considered to have pertussis, as most had no pertussis immunizations. However, B. pertussis isolation was unsuccessful in all cases. As such, diagnoses could not be confirmed. [Paediatr In don es. 2012;5 2: 28-31].

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