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2015 ; 5
(2
): 9-16
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Pertussis: the resurgence of a public health threat
#MMPMID26484329
Torre JA
; Benevides GN
; de Melo AM
; Ferreira CR
Autops Case Rep
2015[Apr]; 5
(2
): 9-16
PMID26484329
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Pertussis is an acute and very contagious pulmonary disease, clinically
characterized by periods of coughing and paroxysms that may cause death. The
disease afflicts mainly the pediatric population and is life threatening to
children under the age of 1 year. Since the beginning of the second millennium,
the number of cases of pertussis has increased, menacing public health, despite
the availability of the pertussis vaccine. The resurgence of the disease among
adults and older children creates a reservoir of infection that will afflict the
unimmunized or incompletely immunized children. As newborns and infants show the
highest mortality rate, immunization during pregnancy is a new strategy to reduce
the burden of pertussis. The authors report the case of a newborn that presented
respiratory distress accompanied by marked leukocytosis. Bronchiolitis was the
initial diagnostic hypothesis, but the clinical picture became typical of
pertussis when paroxysmal coughing ensued. Isolation of the Bordetella pertussis
and antigenic demonstration by polymerase chain reaction were positive from
respiratory secretion. Despite appropriate antibiotic therapy and intensive care
management the child died and the autopsy showed characteristic diagnostic
findings. The authors call attention to this diagnosis when facing respiratory
failure among young children, mainly in the presence of marked leukocytosis.
Thorough research on the immunization status of the patient's social environment
is of crucial importance.
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