Zycinska K, Cieplak M, Chmielewska M, Nitsch-Osuch A, Klaczkow A, Hadzik-Blaszczyk M, Kur Z, Wardyn K A
Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
Adv Exp Med Biol. 2017;955:47-50. doi: 10.1007/5584_2016_167.
Bordetella pertussis is a gram-negative aerobic coccobacillus causing contagious respiratory tract disease called whooping cough. The virulence factors consist of pertussis toxin, filamentous hemagglutinin, fimbriae, lipooligosaccharide, and adenylate cyclase toxin. The disease causes a worldwide threat to public health despite a high vaccination coverage. The course of whooping cough in adults is frequently atypical, causing difficulty in diagnosis. In this report we present five patients hospitalized with Bordetella pertussis infection manifesting atypical and severe symptoms. The diagnosis was based on serological tests: serum concentration of specific antibodies against pertussis toxin and sputum cultures. We observed a wide spectrum of symptoms, from benign (sinus pain - 80 %, headaches - 20 %), through moderate (hemoptysis - 40 %; chest pain 60 %) to severe symptoms (cardiac arrhythmia - 40 %; syncope - 60 %). Bordetella pertussis infection can cause life-threatening complications and exacerbation of concomitant chronic diseases. Most vaccination programs cover only the first few months of life. Booster doses should be considered in adults, especially those immunocompromised or with pulmonary complications, but also in healthcare workers who are exposed to the contagion and also may spread the infection.
百日咳博德特氏菌是一种革兰氏阴性需氧球杆菌，可引起一种名为百日咳的传染性呼吸道疾病。其毒力因子包括百日咳毒素、丝状血凝素、菌毛、脂寡糖和腺苷酸环化酶毒素。尽管疫苗接种覆盖率很高，但该疾病仍对全球公共卫生构成威胁。成人百日咳的病程通常不典型，导致诊断困难。在本报告中，我们介绍了5例因百日咳博德特氏菌感染住院的患者，他们表现出非典型和严重症状。诊断基于血清学检测：抗百日咳毒素特异性抗体的血清浓度和痰培养。我们观察到了广泛的症状，从良性症状（鼻窦疼痛 - 80%，头痛 - 20%），到中度症状（咯血 - 40%；胸痛 - 60%），再到严重症状（心律失常 - 40%；晕厥 - 60%）。百日咳博德特氏菌感染可导致危及生命的并发症，并使伴发的慢性病加重。大多数疫苗接种计划仅覆盖生命的最初几个月。应考虑对成年人进行加强免疫，尤其是那些免疫功能低下或有肺部并发症的人，以及那些接触传染病且可能传播感染的医护人员。
