Pertussis without apparent cough in a disabled girl with a tracheostomy

J Infect Chemother. 2017 Nov;23(11):782-784. doi: 10.1016/j.jiac.2017.05.007. Epub 2017 Jun 13.

Abstract

Pertussis is characterized by intense, prolonged coughing in children often followed by a distinctive whooping sound on inspiration. However, the clinical manifestations and natural course of pertussis in disabled children are largely unknown. We experienced a case of pertussis in a disabled girl who had previously undergone a tracheostomy and laryngotracheal separation. She presented with increased tracheal secretions and required hospitalization but did not develop a cough. Pertussis was suspected from the sputum Gram stain, which revealed numerous, short gram-negative rods that did not grow on chocolate agar. A nucleic acid amplification test was positive for Bordetella pertussis and the patient improved on azithromycin. Pertussis may present without its cardinal symptoms in disabled children.

Keywords: Disabled children; Pertussis; Tracheostomy; Whooping cough.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Bordetella pertussis / immunology
  • Bordetella pertussis / isolation & purification*
  • Child
  • Cough / blood
  • Cough / diagnosis*
  • Cough / drug therapy
  • Cough / microbiology
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage
  • Disabled Persons
  • Disease Transmission, Infectious / prevention & control
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Pertussis Toxin / immunology
  • Radiography
  • Sputum / microbiology*
  • Time Factors
  • Tracheostomy / adverse effects
  • Whooping Cough / blood
  • Whooping Cough / diagnosis*
  • Whooping Cough / drug therapy
  • Whooping Cough / microbiology

Substances

  • Anti-Bacterial Agents
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Immunoglobulin G
  • Azithromycin
  • Pertussis Toxin