Whooping cough (Pertussis; whooping cough) is acute respiratory infections caused by Bordetella pertussis, the clinical features of paroxysmal cough spasm and cough array terminal appears cock inspiratory roar. Duration of up to 2 to 3 months, infants prone to suffocation, and death. More common in children under the age of five. Symptoms paroxysmal continuous cough, and cough after deep inspiration, have a special high-pitched roar.
Whooping cough - a modern medical pathology
Whooping cough prevention of whooping cough bacteria invade the respiratory tract, attached to breed and produce endotoxin in the cilia of airway epithelial cells, causing the destruction of the ciliary dyskinesia and ciliated cells. Extensive inflammation of the bronchial mucosa, increased mucus secretion, cilia damage: accumulation of secretions continue to stimulate the respiratory nerve endings to stimulate the afferent to the cerebral cortex, caused by reflex, spasmodic cough cough center of the cerebral cortex formed excited stove. Therefore, in recovery or have recovered a few months later, crying and other factors can still induce pertussis-like cough.
Whooping cough - clinical performance
The disease severity and duration of disease vary widely, 3 to 21 day incubation period, clinical can be divided into three.
Prodromal period: seen coughing, sneezing, fever and upper respiratory symptoms. 3 to 4 days, the symptoms alleviate, fever disappeared, cough become more intensified, and gradually developed to clonic spasm of the current infectious.
Spasm cough period: 2 to 6 weeks, characterized by paroxysmal spasmodic cough. Frequent short cough attack was breath-state, with a deep inhale, then a cock crow sound of high pitched inspiratory roar, and then cough spasm 1, so repeatedly, until it coughed up a large number of thick sputum or vomiting. Cough spasm when the surface of red lips cyanosis, tongue overhang, jugular vein distention, body bent for lumps. Eyelid edema, eye conjunctival bleeding, nose bleeds, severe cases, intracranial hemorrhage can occur. And ulcers due to friction tongue tie, light condition, the majority of spasm cough is still generally good, as usual demeanor, activity and diet.
Neonates and young infants, the condition is more serious. Due to the weakness of the breathing muscles and thorax, inability to cough, inspiratory tone roar. Tracheal and bronchial stenosis, sputum difficult to expectorate, prone to cause blockage and often paroxysmal breath-hold, cyanosis, asphyxia, and timely for artificial respiration to help breathing recovery. And prone to cerebral hypoxia and convulsions. Early symptoms, severe asphyxia, and poor prognosis.
Recovery period: cough gradually reduced, roar disappear to stop coughing, mental appetite returned to normal. Case of smoke, odor, upper respiratory tract infection, cough spasm may appear again, but lighter. Upper respiratory tract infections and bronchitis more spasm cough disappeared.
Whooping cough - diagnosis
Epidemiology: 1 to 3 weeks before the onset of pertussis exposure history, no history of vaccination.
Clinical manifestations
Pertussis - Laboratory tests
Blood: the precursor of the end to see the WBC count increased, generally in the 15 × 109 / L or more, classified lymphocytes accounted for 60 to 70 percent.
Erythrocyte sedimentation rate: usually normal.
Bacterial culture: cough chatter law directly to the face of the petri dish to the oral cavity in children with a distance of about 3 to 5 cm, cough five to six sound, about to the petri dish into the incubation in a 37 ° C incubator. Nasopharyngeal posterior wall of excretion were cultured. Both early-positive rate of 90%.
The serum agglutination test and complement fixation test: double titer 4-fold increase can be confirmed only for retrospective diagnosis.
Whooping cough - complications
Pneumonia: secondary lung infection.
Encephalitis: more common in small babies. Vomiting, unconsciousness, convulsions, cerebrospinal fluid did not change much.
Deterioration of tuberculosis: tuberculosis deterioration caused by the spread, and meningitis in the tuberculosis systemic miliary tuberculosis or occurs.
Frequency of cough lingual frenulum ulcer; intra-abdominal pressure increased, umbilical hernia, inguinal hernia, rectal prolapse occurs.
Day cough - differential diagnosis
Acute bronchitis: irritating cough and inspiratory laryngeal Ming, fever, hoarseness, cough cock crow-like roar.
Endotracheal foreign body: a history of foreign body aspiration, X-ray examination can help diagnosis.
Bronchial lymph node tuberculosis: hilar lymphadenopathy oppression trachea caused by the array of cough, but the lack of typical cock crow-like echo. According to the TB contact history, tuberculin test, ESR, X-ray examination can be used for identification.
4 whooping cough syndrome: Vice Bordetella pertussis and other bacteria and some viruses may also cause pertussis-like symptoms, the clinical symptoms, blood picture, X-ray found with pertussis are similar, but often be isolated from adenovirus, respiratory viruses, Mycoplasma pneumoniae, or vice Bordetella pertussis, but not isolated from Bordetella pertussis.
Day cough - Introduction
Pertussis Pertussis is a pediatric infectious respiratory disease caused by Bordetella pertussis is highly contagious. The clinical features of cough gradually worsened paroxysmal spasmodic cough, cough the end of the cock crow sound, untreated patients, the course may be continued in March, hence the name "whooping cough". Infant and severe, complicated by pneumonia and encephalopathy.
Whooping cough - therapy
Pertussis. Rest and diet: indoor quiet, fresh air and proper temperature and humidity, to enable the patient to rest quietly. Attention to nutrition, to avoid inducing spasm cough factors.
(2) drug treatment: Early antimicrobial agents available, the preferred erythromycin 30 ~~ 50mg/kg / day, can also be used to chloramphenicol, 30 ~ 50mg/kg / day, efficiency Sulfamethoxazole tablets are also effective. Control spasm cough may at its discretion elect corticosteroids, vitamin K1, pertussis encephalopathy, convulsions, available phenobarbital sodium 5mg/kg intramuscularly, or the stability of each 0.1 ~ 0. 3mg/kg intravenous injection, and the other using mannitol or Yamanashi alcohol each 1 ~ 2g/kg intravenous injection, dexamethasone intravenous drip to reduce intracranial pressure.
Whooping cough - acupuncture
Whooping cough, acupuncture, skin, needle, acupoint injection, and cupping therapy have more satisfactory results. Since the eighties, after the summary further improve the clinical efficacy is more significant. The look on some of the information collected, the efficiency is almost close to 100%. At present, the treatment of this disease in the acupoints on to take on more and Lung Meridian, take care of children with characteristics of needling, bleeding or light stimulus without leaving the needle prick main.
