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WHOOPING COUGH (Management (Macrolide antibiotic as 1st line management -,…
WHOOPING COUGH
Management
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Advise rest, adequate fluid intake, and the use of paracetamol or ibuprofen for symptomatic relief.
Advice on exclusion from nursery, school, or work- 48 hours if antibiotic commenced, 21 days afte onset of syptoms if not treated.
Offer antibiotic prophylaxis to close contacts of the ‘index case’ with suspected or confirmed pertussis (such as those living in the same household).
Clinical features
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The paroxysmal phase -
Typically consist of a short expiratory burst followed by an inspiratory gasp, causing the 'whoop' sound.
Are more common at night, may be triggered by external stimuli (for example cold or noise),
and there may be more than 30 paroxysms in 24 hours.
May yield thick mucous plugs or watery secretions. However, there are usually no other chest signs (such as wheeze or crackles).
May be severe enough to cause cyanosis in children, and are frequently associated with post-tussive vomiting.
The convalescent phase lasts up to 3 months, during which there is a gradual improvement in cough frequency and severity. However, paroxysms can recur with subsequent respiratory infections for many months after the initial infection.
Admission -
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◦Has significant breathing difficulties (for example apnoea episodes,severe paroxysms, or cyanosis).
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Definition
Whooping cough, also known as pertussis, is a highly infectious disease caused by the bacterium Bordetella pertussis, which produces pertussis toxin and other substances which are believed to play an important pathogenic role in the disease.