PERTUSSIS INFECTION IN ADULTS WITH PERSISTENT COUGH

被引:190
作者
WRIGHT, SW
EDWARDS, KM
DECKER, MD
ZELDIN, MH
机构
[1] VANDERBILT UNIV,MED CTR,DEPT PEDIAT,DIV INFECT DIS,NASHVILLE,TN 37232
[2] VANDERBILT UNIV,MED CTR,DEPT PREVENT MED,DIV INFECT DIS,NASHVILLE,TN 37232
[3] VANDERBILT UNIV,MED CTR,DEPT MED,DIV INFECT DIS,NASHVILLE,TN 37232
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1995年 / 273卷 / 13期
关键词
D O I
10.1001/jama.273.13.1044
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective.-To determine the prevalence of Bordetella pertussis infection in adult patients with persistent cough. Design.-Prospective case series. Setting.-Urban university hospital emergency department. Patients.-Convenience sample of 75 patients aged 18 years or older with a cough lasting 2 weeks or longer. Serum specimens from 67 patients without respiratory complaints were used to develop reference values. Interventions.-In patients with cough, nasopharyngeal culture and direct fluorescent antibody testing for B pertussis were performed and serum samples were obtained at the first visit and 1 month later. Serum specimens were assayed for antibody to pertussis toxin (PT) and filamentous hemagglutinin (FHA). Main Outcome Measures.-A subject with one or more of the following was defined as having a pertussis infection: a positive B pertussis culture result, a fourfold change in PT or FHA titer, and/or a single PT or FHA titer at least 2 SDs greater than the geometric mean of the control group. Results.-No subject tested culture positive for B pertussis. Sixteen (21%) (95% confidence interval [CI], 13% to 32%) of 75 subjects met the serologic criteria for pertussis infection; for 13 (81%; 95% CI, 54% to 96%) of the 16, the criteria were met by the initial serum specimen. In contrast, the geometric mean levels of antibody to PT and FHA for the remaining 59 subjects with cough did not differ from those of the control group. Clinical symptoms and the lymphocyte count did not differentiate patients with pertussis from those without the disease. Conclusion.-Pertussis is a common cause of persistent cough in adults and should be considered in the differential diagnosis. Clinical symptoms, pertussis culture, direct fluorescent antibody testing, and lymphocytosis are of limited value in making the diagnosis.
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页码:1044 / 1046
页数:3
相关论文
共 23 条
  • [1] A PERTUSSIS OUTBREAK IN A WISCONSIN NURSING-HOME
    ADDISS, DG
    DAVIS, JP
    MEADE, BD
    BURSTYN, DG
    MEISSNER, M
    ZASTROW, JA
    BERG, JL
    DRINKA, P
    PHILLIPS, R
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1991, 164 (04) : 704 - 710
  • [2] BRAMAN SS, 1985, PRIMARY CARE, V12, P217
  • [3] CHERRY JD, 1989, WESTERN J MED, V150, P319
  • [4] THE 1993 EPIDEMIC OF PERTUSSIS IN CINCINNATI - RESURGENCE OF DISEASE IN A HIGHLY IMMUNIZED POPULATION OF CHILDREN
    CHRISTIE, CDC
    MARX, ML
    MARCHANT, CD
    REISING, SF
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (01) : 16 - 21
  • [5] UNRECOGNIZED PERTUSSIS INFECTION IN ADOLESCENTS
    CROMER, BA
    GOYDOS, J
    HACKELL, J
    MEZZATESTA, J
    DEKKER, C
    MORTIMER, EA
    [J]. AMERICAN JOURNAL OF DISEASES OF CHILDREN, 1993, 147 (05): : 575 - 577
  • [6] ADULT IMMUNIZATION WITH ACELLULAR PERTUSSIS-VACCINE
    EDWARDS, KM
    DECKER, MD
    GRAHAM, BS
    MEZZATESTA, J
    SCOTT, J
    HACKELL, J
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (01): : 53 - 56
  • [7] EPIDEMIOLOGIC FEATURES OF PERTUSSIS IN THE UNITED-STATES, 1980-1989
    FARIZO, KM
    COCHI, SL
    ZELL, ER
    BRINK, EW
    WASSILAK, SG
    PATRIARCA, PA
    [J]. CLINICAL INFECTIOUS DISEASES, 1992, 14 (03) : 708 - 719
  • [8] SENSITIVE AND SPECIFIC POLYMERASE CHAIN-REACTION ASSAYS FOR DETECTION OF BORDETELLA-PERTUSSIS IN NASOPHARYNGEAL SPECIMENS
    HE, QS
    MERTSOLA, J
    SOINI, H
    VILJANEN, MK
    [J]. JOURNAL OF PEDIATRICS, 1994, 124 (03) : 421 - 426
  • [9] PERTUSSIS AND PERTUSSIS VACCINES IN ADULTS
    HERWALDT, LA
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (01): : 93 - 94
  • [10] HERWALDT LA, 1991, ARCH INTERN MED, V109, P1510