Clinical profile of patients with suspected whooping cough in a pediatric hospital and operational difficulties in laboratory confirmation
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Abstract
Introduction: whooping cough is an acute infectious disease of high infant morbidity and mortality. Diagnostic tests are expensive and often not available. Objective: to describe the clinical and epidemiological characteristics of patients with suspected pertussis from 2010 to 2015 and difficulties in laboratory confirmation. Methods: retrospective descriptive longitudinal study of children reported with suspected pertussis in a pediatric
hospital in the period from 2010 to 2015. Data was collected from pertussis notification/
investigation records and medical records, being stored and analyzed in Epi Info®. The descriptive statistics were applied for the categorical variables, regarding frequency and percentage, and for the continuous ones, the mean and median were calculated. Results:
64 children were reported as suspected cases of pertussis. 70% were less than 6 months
old with a slight predominance in females. The most commonly reported symptoms were
cough (100%), paroxysmal cough (82%) and cyanosis (75%). In the initial laboratory tests,
48% had leukocytosis of 20,000/mm3 or more and 47% lymphocytosis equal to or greater
than 10,000/mm3. In the specific test, no sample was tested positive for Bordetella pertussis by culture method. Among the complications, pneumonia was the most frequent (86%) and 11% of the patients died. Conclusions: whooping cough is more prevalent in infants who have not yet been protected by the vaccine and who may develop severe illness. Its laboratory confirmation remains a challenge, and the pediatrician should be sensitive to clinical suspicion, promoting early treatment to reduce morbidity and mortality.
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