Nozawa Hisataka, Shoji Kensuke, Uda Kazuhiro, Nakamura Tomoo, Kubota Mitsuru, Ishiguro Akira, Miyairi Isao
Department of Postgraduate Education and Training, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.
Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.
J Infect Chemother. 2017 Nov;23(11):782-784. doi: 10.1016/j.jiac.2017.05.007. Epub 2017 Jun 13.
Pertussis is characterized by intense, prolonged coughing in children often followed by a distinctive whooping sound on inspiration. However, the clinical manifestations and natural course of pertussis in disabled children are largely unknown. We experienced a case of pertussis in a disabled girl who had previously undergone a tracheostomy and laryngotracheal separation. She presented with increased tracheal secretions and required hospitalization but did not develop a cough. Pertussis was suspected from the sputum Gram stain, which revealed numerous, short gram-negative rods that did not grow on chocolate agar. A nucleic acid amplification test was positive for Bordetella pertussis and the patient improved on azithromycin. Pertussis may present without its cardinal symptoms in disabled children.
百日咳的特征是儿童剧烈、持续咳嗽，通常在吸气时伴有独特的哮吼声。然而，残疾儿童百日咳的临床表现和自然病程在很大程度上尚不清楚。我们遇到一例残疾女孩患百日咳的病例，该女孩此前接受过气管切开术和喉气管分离术。她出现气管分泌物增多，需要住院治疗，但未出现咳嗽症状。痰革兰氏染色怀疑为百日咳，显示有大量短革兰氏阴性杆菌，在巧克力琼脂上不生长。核酸扩增试验百日咳博德特氏菌呈阳性，患者使用阿奇霉素后病情好转。残疾儿童百日咳可能不出现其主要症状。
