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What causes whooping cough?
Last reviewed: 23.04.2024
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Causes of Pertussis
Pertussis is caused by Bordetella pertussis - gram-negative small sticks (coccobacteria). They have a gentle capsule, immobile, strict aerobes, highly sensitive to external influences: direct sunlight kills for 1 hour, disinfectants - for several minutes, produces exotoxin (pertussis toxin, lymphocytic stimulating factor). In addition, the antigenic structure of pertussis causative agent includes filamentous hemagglutinin, protective agglutininogen, tracheal cytotoxin, dermonecrotoxin, hemolysin, etc.
Pathogenesis of whooping cough
Bordetella pertussis falls on the mucous membrane of the upper respiratory tract, multiplies in cells of the cylindrical epithelium and spreads through the bronchial tubes along the small bronchi, bronchioles and alveoli. Pertussis is not accompanied by bacteremia. The main role in the pathogenesis belongs to the toxin, which, acting on the mucous membrane of the respiratory tract, causes a cough. As a result of prolonged irritation of the nerve receptors in the mucous membrane of the respiratory tract with toxin, coughing takes the character of spasmodic attacks, during which the rhythm of respiration (inspiratory pauses) is disturbed. Violation of the rhythm of breathing with spasmodic cough (apnea) leads to impairment of pulmonary ventilation, hemodynamic disorder, which is accompanied by hypoxia and hypoxemia. Hemocirculatory disorders in the cerebral cortex may be accompanied by focal changes and seizures. In the medulla oblongata, where the flow of impulses continuously flows, in connection with prolonged irritation of the receptor apparatus of the respiratory tract, a stable focus of excitation is formed by the AA dominant type. Ukhtomsky. Various nonspecific stimuli lead to an increase in spasmodic cough.