Rapid Review: Pertussis (Whooping Cough)

Pertussis (Whooping Cough)

• Patient with a history of nasal congestion, cough, and low-grade fever
• “Rapid fire,” repetitive coughing followed by an inspiratory “whoop” and post-tussive emesis
• Most commonly caused by Bordetella pertussis
• Treatment is a macrolide – azithromycin

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Sample question: 

A 2-year-old boy who is new to your practice is brought to the clinic because of coughing. For the past two weeks, he has had rhinorrhea and coughing. However, the coughing has become worse with more frequent coughing fits and episodes of vomiting. You review his previous records and note that the parents have refused immunizations. On physical examination, his temperature is 38 degrees Celsius, respiratory rate is 35, and lungs are clear to auscultation. During the examination, you note that the boy has a long series of coughs followed by a whoop. Which of the following is the most likely etiologic agent causing the illness?