TY - CHAP M1 - Book, Section TI - Pertussis A1 - Mace, Sharon E. A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert Y1 - 2019 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Pertussis can occur in any age group, but is most severe in infants <4 to 6 months.Consider pertussis in patients of any age with a persistent cough.Consider pertussis even in vaccinated individuals, since immunity wanes within a few years after immunization.Initiate antibiotic therapy with a macrolide (azithromycin is preferred) prior to obtaining test results, especially in infants, pregnant women, and those in close contact with them.The classic presentation has three stages: catarrhal with nonspecific upper respiratory tract symptoms, paroxysmal phase with a severe “whooping” cough, and convalescent phase with less severe coughing, but the presentation may be atypical.Lymphocytosis is typical, but is not always present, and fever is usually absent unless there is secondary bacterial infection.Indications for hospital admission include infants <4 to 6 months, dehydration, and those with respiratory, neurologic, or cardiac complications. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/12 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1155296847 ER -