Author: Julian Orenstein, M.D.

Educational Pearls

• Colorado has a high population of unvaccinated children, and is at increased risk for pertussis outbreaks.
• The causative organism is Bordetella pertussis. It causes causes respiratory epithelial necrosis leading to congestion of the bronchioles, leading to cough.
• The cough is unique - it is usually a series of expiratory coughs followed by one deep inspiration
• The clinical presentation is divided into 3 phases:
• • Catarrhal: cough and congestion with low-grade fever and coryza.
  • Whooping: characteristic cough.
  • Resolution: recovery with persistent cough.
• Infants may not get this presentation, but may get apnea and nonspecific cough.
• Tongue depressor can be used to elicit cough for diagnosis.

References: Tozzi AE, Pastore Celentano L, Ciofi degli Atti ML, Salmaso S. Diagnosis and management of pertussis. CMAJ : Canadian Medical Association Journal. 2005;172(4):509-515. doi:10.1503/cmaj.1040766.