A 36 yo woman came in with her 9 month old baby. The woman has "suffered from cough" for months and now her child is also suffering. She has been to the doctor and received an African version of the antibiotic Bactrim and medication for a cough syrup. However, she only had enough money to buy a weeks supply of each. She came to Ellen and had a fit of coughing in the room. It was very violent and hard to watch. She said that her baby also coughs until he vomits.
The history was consistent with pertussis, also known as whopping cough. The coughing is paroxysmal and violent, often leading to vomiting, and it has lasted over a month. She had already been on a quinolone and Bactrim which don't completely cover the bacteria causing pertussis. It was transmitted easily to her child making it most likely an infectious etiology.
On auscultation I could definitely hear wheezes and rhonchi, but no crackles, ruling out pneumonia. She also had an Xray that ruled out TB and showed no infiltrates.
Pertussis is caused by either B. pertussis or B. parapertussis, both respond to erythromycin. In infants there is a significant risk of death. In the United States children are immunized for this disease with the DPT vaccine.
1 comment:
Forgive me Erika! Let me know if I should restrain my comments. I am just so excited about all of the experiences you are having. You could go your whole professional life here in the states and never see a case of pertussis. I hope she is recovering. Because of you I am getting a taste of being a risk taker. Annie
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