* Bordetella pertussis (Bordet and Gengou bacillus) Gram-negative bacilli cultivable aerobic.
Contamination is air (infectiousness continues after 3 weeks of the catarrhal phase).
The bacteria are multiple on the ciliated respiratory epithelium and secretes several toxins.
Pertussis is a poisoning.
* The invasion period (or catarrhal) lasts 7 to 15 days.
Intractable cough gradually becomes spasmodic, émitisante at night max. Low-grade fever
* Paroxysmal coughing period lasts on average 4 to 5 weeks.
The temperature is normal.
The fifth is made from March to May paroxysms (cough shake series, produced in the same expiration with loud deep breath hull vocals) times (10 to 15) jusqu’apparaisse expectoration.
The frequency of fifths gradually increases to 10-20 / day.
* The whooping tic can still be observed for 4 to 5 months after this period.
* 50% of the darlings occur before the age of 1 year.
Pertussis in infants is severe (coughing asphyxiating, syncopal apnea, respiratory massive congestion, atelectasis, secondary infections).
* NFS: leukocytosis strong stroke lymphocytosis.
A thrombocytosis is a severity criterion (> 500,000 / mm3).
* Identification of B. pertussis in respiratory secretions is the only certainty argument (lack of healthy carrier).
Serology (good compromise).
* Complications: ulceration of the tongue-tie; superinfection;convulsions ….
* A pertussis syndrome can be observed with certain adenoviruses …
* Hospitalization should be routine for infants under 3 months;antibiotic treatment does not alter the course of the disease when it is prescribed in however it is recommended paroxysmal period in order to eradicate the disease (erythromycin for 14days or Bactrim if CI).
* Corticosteroids (systemically) are prescribed only in severe cases.
They reduce the intensity of fifths.
* The Antibiotic of the entourage (a macrolide for 10 days) is systematic (regardless of age and vaccination status);updated immunization schedule.
* School Eviction 30 days.
