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2016 ; 63
(suppl 4
): S119-S122
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Pertussis in Young Infants Throughout the World
#MMPMID27838663
Cherry JD
Clin Infect Dis
2016[Dec]; 63
(suppl 4
): S119-S122
PMID27838663
show ga
In typical pertussis in young infants, the child will appear deceptively well; he
or she will have coryza, sneezing, and a mild cough. There is no fever. This
progresses to gagging, gasping, eye bulging, bradycardia, cyanosis, and vomiting.
There is leukocytosis with lymphocytosis and apneic episodes. Deaths relate to
leukocytosis, pulmonary hypertension, and pneumonia. The source of pertussis in
young infants is most often a family member with cough illness that is not
recognized as pertussis. Diagnosis is based on culture/polymerase chain reaction
and leukocytosis with lymphocytosis. Treatment depends on macrolide antibiotic
therapy and intubation, with assisted ventilation and oxygen. Prevention is based
on prophylactic macrolide treatment, immunization starting at 6 weeks of age, and
immunization of all pregnant women in the second or third trimester.