BACKGROUND: Pertussis, also known as whooping cough, is an acute respiratory illness primarily caused by Bordetella pertussis. Highly contagious, it poses significant morbidity and mortality risks, especially in infants. Despite widespread vaccination efforts, pertussis cases have recently resurged globally. This case report details possible complication in a 48-year-old woman, involving a cough-induced rib fracture and recurrent pneumothorax, highlighting the need for considering pertussis in patients with severe cough and back pain. CASE PRESENTATION: A 48-year-old female non-smoker with hypertension, treated with ACE inhibitor (perindopril), presented with a runny nose, productive cough, and back pain. Initial treatment for a common cold provided temporary relief. However, her symptoms worsened, and further examination revealed a fractured rib, pneumothorax, and subcutaneous emphysema. Laboratory tests confirmed elevated Bordetella pertussis toxin antibodies. She was treated with antibiotics, and despite recurrent symptoms, a conservative management approach was successful. Follow-up indicated resolution of symptoms, but significant anxiety related to her condition. CONCLUSION: This case emphasises the importance of considering pertussis in adults, as early symptoms resembling a common cold can lead to misdiagnosis. It also highlights the potential for significant musculoskeletal and pulmonary injuries due to intense coughing associated with pertussis. Prompt diagnosis and comprehensive management, including antibiotics and supportive care, are essential for favorable outcomes.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Bordetella pertussis isolation & purification MeSH
- Rib Fractures * complications MeSH
- Cough etiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Whooping Cough * complications drug therapy MeSH
- Pneumothorax * etiology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
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- MeSH
- Diphtheria * prevention & control MeSH
- Vaccines, Combined pharmacology therapeutic use MeSH
- Humans MeSH
- Whooping Cough * prevention & control MeSH
- Pertussis Vaccine administration & dosage pharmacology therapeutic use MeSH
- Tetanus * prevention & control MeSH
- Diphtheria-Tetanus-Pertussis Vaccine * administration & dosage pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Černý kašel je vysoce nakažlivé bakteriální onemocnění postihující řasinkový epitel respiračního traktu. Jedná se o kapénkovou infekci, která se snadno šíří především v populaci vnímavých jedinců (novorozenci, kojenci). Onemocnění se projevuje záchvaty dráždivého kašle, v dětském věku a u rizikových skupin (senioři, imunosuprimovaní, osoby s chronickým onemocněním plic) může mít komplikovaný až fatální průběh. Před objevem vakcíny byla tato infekce častou příčinou kojenecké morbidity a mortality, v současnosti je v České republice vakcína proti pertusi součástí povinného očkování v kojeneckém věku. V rámci ochrany nejmenších dětí, jež jsou infekcí nejvíce ohroženy, je také doporučeno přeočkování těhotných žen ve 3. trimestru gravidity. Jelikož je v letošním roce počet hlášených případů pertuse opět na vzestupu, je vhodné si zopakovat základní informace o infekci a seznámit se s aktuálními doporučeními.
Whooping cough is a highly contagious bacterial disease that affects the ciliated epithelium of the respiratory tract. The disease is transmitted by the inhalation of infected droplets and easily spreads mainly in the population of responsive subjects (newborns, infants). The disease manifests by a paroxysmal unproductive cough, in childhood, and in a high-risk group of people (seniors, immunosuppressed patients, and patients with chronic lung disease) can have a complicated or fatal course. This infection was a frequent cause of infant morbidity and mortality before the development of the vaccine, in present the vaccine against pertussis is a part of mandatory vaccination in infant age in the Czech Republic. In protection of the smallest children, which are mostly threatened by whooping cough, is also recommended a revaccination during pregnancy between 27 and 36 weeks gestation. Cause of the increase in pertussis cases this year, it's good to repeat basic information about the infection and also get to know current recommendations.
- MeSH
- Anti-Bacterial Agents administration & dosage therapeutic use MeSH
- Bordetella pertussis pathogenicity MeSH
- Humans MeSH
- Whooping Cough * diagnosis epidemiology drug therapy MeSH
- Pertussis Vaccine MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND: Bordetella pertussis continues to cause whooping cough globally even in countries with high immunisation coverage. Booster vaccinations with acellular pertussis vaccines are thus used in children, adolescents, and adults. T cell immunity is crucial for orchestrating the immune response after vaccination. However, T cell assays can be expensive and difficult to implement in large clinical trials. In this study, a whole blood (WB) stimulation assay was developed to identify secreted T cell associated cytokines in different age groups after acellular pertussis booster vaccination. MATERIAL AND METHODS: Longitudinal WB samples were collected from a small set of subjects (n = 38) aged 7-70 years participating in a larger ongoing clinical trial. For assay development, samples were diluted and incubated with purified inactivated pertussis toxin (PT), filamentous haemagglutinin (FHA), inactivated B. pertussis lysate, and complete medium (M) as stimulating conditions, with anti-CD28 and anti-CD49d as co-stimulants. Different timepoints around the vaccination (D0, D7, D14, D28), WB dilution factor (1:2, 1:4) and incubation time (24 h, 48 h, 72 h) were compared. Responses to 15 cytokines were tested with Luminex/multiplex immunoassay. RESULTS: The optimized assay consisted of WB incubation with M, PT, and FHA (including the two co-stimulants). After 48 h incubation, supernatants were collected for measurement of seven selected T cell associated cytokines (IL-2, IL-5, IL-10, IL-13, IL-17 A, IL-17F, and IFN-y) from samples before and 28 days after vaccination. PT stimulation showed a trend for upregulation of IL-2, IL-13, and IL-17 A/F for adult subjects, whereas the responses of all cytokines were downregulated for the paediatric subjects. Furthermore, PT and FHA-stimulated WB showed diverse cytokine producing profiles. CONCLUSIONS: The developed WB-based cytokine assay was shown to be less costly, easy to perform, and functional in differently aged individuals. Further, it requires only a small amount of fresh blood, which is beneficial especially for studies including infants. Our results support the use of this assay for other immunological studies in the future.
- MeSH
- Antigens, Bacterial * immunology MeSH
- Bordetella pertussis * immunology MeSH
- Cytokines * blood immunology MeSH
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Whooping Cough * immunology blood prevention & control MeSH
- Pertussis Vaccine * immunology administration & dosage MeSH
- Immunization, Secondary MeSH
- Aged MeSH
- T-Lymphocytes * immunology MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Vaccines, Combined MeSH
- Humans MeSH
- Whooping Cough * diagnosis epidemiology prevention & control MeSH
- Pertussis Vaccine MeSH
- Vaccination MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Anti-Bacterial Agents administration & dosage therapeutic use MeSH
- Antibiotic Prophylaxis MeSH
- Bordetella pertussis isolation & purification MeSH
- Disease Notification MeSH
- Humans MeSH
- Macrolides administration & dosage therapeutic use MeSH
- Whooping Cough * diagnosis drug therapy prevention & control MeSH
- Polymerase Chain Reaction MeSH
- Vaccination MeSH
- Check Tag
- Humans MeSH
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Antibiotic Prophylaxis MeSH
- Disease Notification MeSH
- Immunoglobulin A blood MeSH
- Immunoglobulin G blood MeSH
- Whooping Cough * diagnosis therapy MeSH
- Primary Prevention MeSH
- Serologic Tests MeSH
- Diphtheria-Tetanus-acellular Pertussis Vaccines MeSH
- Publication type
- Practice Guideline MeSH
- MeSH
- Bordetella pertussis isolation & purification MeSH
- Child MeSH
- Disease Outbreaks * MeSH
- Infant MeSH
- Humans MeSH
- Whooping Cough * epidemiology prevention & control MeSH
- Pertussis Vaccine administration & dosage MeSH
- Child, Preschool MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Letter MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Bordetella pertussis MeSH
- Humans MeSH
- Whooping Cough * epidemiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
