Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
January
VOLUME 52
NUMBER 1
Original Article
Abstract
Background Recent reports of pertussis epidemiology from Asia,
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of pertussis is due to lack of access to diagnostic methods,
misdiagnoses, under-reporting, and different countries reporting
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resembling whooping cough (pertussis) has also been defined as
pertussis-like syndrome.
Objective 7R UHSRUW HOHYHQ FDVHV RI SHUWXVVLV RU SHUWXVVLV OLNH
syndrome in the pediatric ward of Hasan Sadikin Hospital.
Methods 7KLV UHWURVSHFWLYH VWXG\ ZDV FRQGXFWHG E\ UHYLHZLQJ
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like syndrome patients were documented including age, gender,
history of pertussis immunization, clinical manifestations,
laboratory findings, initial diagnosis, treatment and clinical
response. Isolation of Bordetella pertussis XVLQJ %RUGHW *HQJRX
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two classifications: probable and confirmed.
Results (OHYHQ SDWLHQWV ZHUH GLDJQRVHG ZLWK SHUWXVVLV OLNH
syndrome, including 5 boys and 6 girls. Most subjects were less
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were the most common symptoms. All were initially diagnosed
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and cyanosis, while none had apneic symptoms. All B. pertussis
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clarithromycin showed good clinical responses.
Conclusion $OO LQIDQWV ZHUH OLNHO\ FRQVLGHUHG WR KDYH SHUWXVVLV
DV PRVW KDG QR SHUWXVVLV LPPXQL]DWLRQV +RZHYHU B. pertussis
isolation was unsuccessful in all cases. As such, diagnoses could
not be confirmed. [Paediatr Indones. 2012;52:28-31].
Keywords: Pertussis, pertussis-like syndrome,
Bordet-Gengou agar, clarithromycin
Heda Melinda Nataprawira et al: 3HUWXVVLV OLNH V\QGURPH RU SHUWXVVLV D GHOD\ GLDJQRVLV
Methods
All pediatric inpatients in Hasan Sadikin Hospital
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medical records and our own pertussis or pertussis-like
syndrome registry.
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&'& 6 which was reformatted for clarification in
the diagnosis of pertussis was based on two
case classifications: (1) probable, a case that meets
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weeks with at least one of the following: paroxysms
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by a health professional), is not laboratory confirmed,
and is not epidemiologically linked to a laboratoryconfirmed case; and (2) confirmed, a case of acute
cough illness of any duration with isolation of B.
pertussis from a clinical specimen, or a case that meets
n=11
Gender, n
Male
Age distribution, n
0-1 months
1-6 months
6-12 months
Symptoms present
Cough, n
Average length of cough, days
Fever, n
Dyspnea, n
Average length of dyspnea, days
Cyanosis, n
Vomiting, n
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Lymphocytosis due to leukocytosis, n
Bordet Gengou cultures
Positive, n
Negative, n
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Probable, n
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Previous DTP immunization, n
Macrolide (clarithromycin) treatment
1
9
1
11
10.5
9
9
2
3
3
5
0
10
11
0
1
11
Results
Of all of pediatric inpatients admitted during
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syndrome. Subjects ages ranged from 1 to 12
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age group. Male to female ratio was similar. The
leading symptoms at presentation were dyspnea and
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duration of symptoms before coming to the hospital
Heda Melinda Nataprawira et al: 3HUWXVVLV OLNH V\QGURPH RU SHUWXVVLV D GHOD\ GLDJQRVLV
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initiation of macrolide antibiotic treatment in the
ward after the initial hospital presentation was 4 days.
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Leukocytosis with absolute lymphocytosis was
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classifications (probable and confirmed), all 11
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after probable pertussis or pertussis-like syndrome
was diagnosed. 8 3DWLHQWV VKRZHG JRRG FOLQLFDO
response.
Discussion
We only documented 11 patients with pertussis-like
syndrome in the study period from Hasan Sadikin
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highest burden in the unimmunised age groups. 1
Although pertussis could not be confirmed, we
assumed that all patients had probable pertussis.
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throughout the course of illness.4
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cyanosis while none reported apneic symptoms.
Classic whooping cough is characterized by three
distinct stages of illness where initial symptoms are
non-specific, sometimes resembling a cold or other
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the initial catarrhal stage, the cough becomes
predominant. Continuing to the paroxysmal stage,
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and hard whooping, partial whooping, or no whooping,
which makes it difficult for clinicians to identify the
disease. Whooping cough is most contagious during
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increased toxin production associated with pertussis
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References