Francis Centeno M, Borque Andrés C, del Castillo Martín F, Díez Sebastián J, García Hortelano J
Hospital Infantil La Paz, Servicio de Enfermedades Infecciosas, Madrid.
An Esp Pediatr. 1998 Sep;49(3):280-3.
Our objective was to study the whooping cough cases diagnosed in a 15-year period in our hospital, referring to its clinical features, epidemiology and analytical findings.
A retrospective study based on 144 cases with a clinical diagnosis of whooping cough, from 1981 to 1995, was carried out. Special attention was paid to those cases with cultures positive for B. pertussis.
Nasopharyngeal specimens for culture were taken in 119 cases. This was not carried-out in those with previous antibiotic therapy. Cultures were positive for B. pertussis in 46 patients (38.7%). The age varied between 20 days and 30 months. Twenty-one were female. The initial symptoms were: paroxysmal cough in 44 (95.7%), cyanosis in 34 (73.9%), inspiratory whoop in 27 (58.7%), respiratory distress in 12 (26.1%) and post-tussive vomiting in 10 (21.7%). Thirty-nine children (84.8%) of this group had not received any pertussis vaccine, the rest had received just the first dose. It had been contacted by persons having cough in 19 patients (41.3%). Leukocytosis (mean: 19,818/mm3), lymphocytosis (mean: 13,047/mm3) and high platelet count (mean 459,522/mm3) were common findings.
Cultures were positive in 38.7% of the patients. There are similar findings by other authors. In this group, most of the children were unvaccinated, and less than 3 months of age. Typical symptoms of pertussis were observed in the majority of patients. In one forth of them respiratory distress was found, probably related to their young age. Vaccinated adults emerge as a contact group that should be studied.
我们的目的是研究我院15年间诊断的百日咳病例,参考其临床特征、流行病学及分析结果。
对1981年至1995年间临床诊断为百日咳的144例患者进行回顾性研究。特别关注那些百日咳杆菌培养阳性的病例。
119例患者采集了鼻咽部培养标本。先前接受过抗生素治疗的患者未进行此项检查。46例患者(38.7%)的培养结果显示百日咳杆菌阳性。年龄在20天至30个月之间。21例为女性。初始症状为:阵发性咳嗽44例(95.7%)、发绀34例(73.9%)、吸气性吼声27例(58.7%)、呼吸窘迫12例(26.1%)、咳嗽后呕吐10例(21.7%)。该组中39名儿童(84.8%)未接种任何百日咳疫苗,其余仅接种了第一剂。19例患者(41.3%)与咳嗽患者有接触史。白细胞增多(平均:19,818/mm³)、淋巴细胞增多(平均:13,047/mm³)及血小板计数升高(平均459,522/mm³)是常见表现。
38.7%的患者培养结果呈阳性。其他作者也有类似发现。该组中大多数儿童未接种疫苗,且年龄小于3个月。大多数患者出现百日咳的典型症状。其中四分之一的患者出现呼吸窘迫,可能与年龄小有关。接种疫苗的成年人作为一个接触群体应进行研究。