title: Whooping Cough in Adults: A Series of Severe Cases.
abstract: 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.
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland. kzycinska@poczta.fm.
authors.forename: K
authors.initials: K
authors.lastname: Zycinska
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Cieplak
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Chmielewska
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Nitsch-Osuch
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Klaczkow
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Hadzik-Blaszczyk
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: Z
authors.initials: Z
authors.lastname: Kur
authors.affiliation: Department of Family Medicine with Internal and Metabolic Diseases Ward, Warsaw Medical University, 19/25 Stępinska Street, 00-739, Warsaw, Poland.
authors.forename: K A
authors.initials: KA
authors.lastname: Wardyn
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001431:Bacteriological Techniques; D001886:Bordetella pertussis / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008875:Middle Aged; D010567:Pertussis Vaccine / Q000008:administration & dosage; D012698:Serologic Tests; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014917:Whooping Cough / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D010567:Pertussis Vaccine
keywords: Bordetella pertussis; Cardiac arrhythmia; Chronic cough; Syncope; Vaccination booster; Whooping cough