Pertussis – Clinical features, Stages, Complications

  • Pertussis is caused by the bacterium Bordetella pertussis
  • It invades the respiratory tract and causes inflammation and necrosis of surface epithelium resulting in secondary infections
  • There are 3 stages in the clinical course of pertussis

Stages of Pertussis

  • Catarrhal stage
    • Lasts for about 10 days
    • Insidious onset
    • Lacrimation, coryza, sneezing, mild fever, cough, anorexia and malaise are the features of this stage
  • Paroxysmal stage
    • Lasts for 2-4 weeks
    • Bouts of cough followed by an inspiratory crowing sound (whoop) is classically present
    • Apnoea and cyanosis can occur in infants
  • Convalescence stage
    • Lasts for 1-2 weeks

Complications:

  • Complications tend to occur in infants below 6 months of age
  • Commonly seen complications are:
    • Bronchitis
    • Bronchopneumonia
    • Bronchiectasis
  • Rare complications:
    • Encephalopathy
  • The recurrent bouts of cough can result in:
    • Subconjunctival haemorrhage
    • Epistaxis
    • Haemoptysis
    • Punctate cerebral haemorrhage (can result in convulsions and coma)

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