Jones Thomas C, Gasser Markus, Erb Peter, Oechslin Hanspeter
Clinical Research Consultants, Switzerland.
Braz J Infect Dis. 2004 Aug;8(4):324-7. doi: 10.1590/s1413-86702004000400009. Epub 2004 Nov 19.
Pertussis is increasing in frequency among adults, but early diagnosis requires special attention to details in the medical history. We describe a 64 year-old male with classic signs and symptoms of pertussis and documented Bordetella pertussis infection that were overlooked because he presented with a chief complaint of cough and fear of falling asleep. Coughing paroxysms and a feeling of suffocation (30-60 seconds) only occurred at night after short periods of deep sleep (30-45 minutes). The physicians did not observe these episodes during daytime examinations, and the basis of the patient's fear of sleep was not explored. We recommend reassessment of how adults describe symptoms of pertussis, including fear of sleep, and we suggest the use of PCR technology to allow early diagnosis and prompt treatment.
百日咳在成年人中的发病率正在上升，但早期诊断需要特别关注病史细节。我们描述了一名64岁男性，他有百日咳的典型体征和症状，且确诊感染百日咳博德特氏菌，但这些都被忽视了，因为他的主要诉求是咳嗽和害怕入睡。咳嗽阵发性发作和窒息感（30 - 60秒）仅在短时间深度睡眠（30 - 45分钟）后的夜间出现。医生在白天检查时未观察到这些发作情况，也未探究患者害怕睡眠的原因。我们建议重新评估成年人描述百日咳症状的方式，包括对睡眠的恐惧，并建议使用聚合酶链反应（PCR）技术以实现早期诊断和及时治疗。
