About this episode
Author: Julian Orenstein, M.D. Educational Pearls Colorado has a high population of unvaccinated children, and is at increased risk for pertussis outbreaks. The causative organism is Bordetella pertussis . It causes causes respiratory epithelial necrosis leading to congestion of the bronchioles, leading to cough. The cough is unique - it is usually a series of expiratory coughs followed by one deep inspiration The clinical presentation is divided into 3 phases: Catarrhal: cough and congestion with low-grade fever and coryza. Whooping: characteristic cough. Resolution: recovery with persistent cough. Infants may not get this presentation, but may get apnea and nonspecific cough. Tongue depressor can be used to elicit cough for diagnosis. References: Tozzi AE, Pastore Celentano L, Ciofi degli Atti ML, Salmaso S. Diagnosis and management of pertussis. CMAJ : Canadian Medical Association Journal . 2005;172(4):509-515. doi:10.1503/cmaj.1040766.