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Diagnosis of pertussis
Last reviewed: 23.04.2024
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Diagnosis of whooping cough is based on a typical clinical picture of the disease.
As a rapid diagnosis of whooping cough, the immunofluorescent method is used, with which the pertussis causative agent can be detected directly in the mucus slime from the nasopharynx almost in all patients at the onset of the disease.
Serological diagnosis of whooping cough is based on the use of RA, RSK and RPHA - the detection of antibodies to Bordetella pertussis in the serum. These reactions are important only for retrospective diagnosis and, in addition, they are often negative in children of the first 2 years of life. The first serum should be examined no later than the 3rd week after the onset of the disease, the second - after 1-2 weeks.
[Differential diagnosis of pertussis
In the catarrhal period, pertussis in children should be differentiated from ARVI (influenza, parainfluenza, adenovirus infection, respiratory syncytial infection, etc.). Pertussis differs from acute respiratory viral infections with mild catarrhal symptoms on the nasal mucosa and oropharynx, often with normal body temperature, absence of intoxication, gradually progressive cough, despite ongoing treatment, high leukocytosis and lymphocytosis.
In the spasmodic period, whooping cough should be differentiated from ARVI, occurring with obstructive syndrome; with tubercular bronchoadenitis, foreign body, spasmophilia with laryngospasm, rarely with bronchial asthma, mediastinal tumors, etc.
Cyclical disease, a typical spasmodic cough with reprises, hematologic changes, and epidemiological data help to diagnose whooping cough.
It is more difficult to differentiate pertussis and paracutosis, in which cough can also become spasmodic. However, the paracolus is much lighter than whooping cough. Pertussis cough lasts from a few days to 2 weeks. The hemogram is usually unchanged. Critical in the diagnosis are bacteriological and to a lesser extent serological studies.