Lec 2 pertussis & jaundice

1. PERTUSSIS
(whooping cough)

2. PERTUSSIS
an acute respiratory tract
infection that was described by
as pertussis, meaning intense
cough, it is preferable to
whooping cough because most
infected individuals do not
“whoop.”

3. ETIOLOGY
 Bordetella pertussis, gram negative coccobacilli

4. EPIDEMIOLOGY
 Spread occurs by direct contact or droplet
infections during cough.
 Infants less than one year of age constitute 50-70%
of diagnosed cases.
Period of communicability
•The disease occurs 3-12 days after exposure to
an infected individual
•The coughing stage lasts for approximately six
weeks before subsiding. In some countries, this
disease is called the 100 days' cough or cough
of 100 days because of its length.

5. CLINICAL
MANIFESTATIONS:
The incubation period of pertussis
has a mean of 7 and a range of 6-20
days.
Classically, divided into:
1- Catarrhal,
2 Paroxysmal, and
3 Convalescent stages.

6. CATARRHAL
STAGE
 The term "catarrh" is derived from
meaning "tohistoric Middle English,
flow." That is, secretions from the
noseand mucous membranes flow, causing
nasal congestion and runny nose.
 Nasal congestion
 Runny nose
 Mild fever
 Eye redness and excess eye watering

7. (Paroxysmal stage)
start as a dry, intermittent, annoying cough
that increases in intensity and frequency
 occur at least once an hour
 cause the child to turn red, blue, or purple
 cause the eyes to bulge and water
excessively
 cause significant distress in the child
 have a "machine-gun" pattern
 vomiting after coughing

8. CONVALESCENT
STAGE (≥2 WK)
 The coughing fits become less frequent and
less intense. Young infants may develop
louder coughing but typically the breathing
difficulty improves.

9. COMPLICATIONS OF PERTUSSIS?
 Apnea
 Ear infections
 Pneumonia
 Seizures
 Encephalopathy (brain damage)
 Death

10. Treatment
 Hospitalization is common, especially for
infants less than 6 months. Respiratory
support such as supplemental oxygen or even
mechanical venitlation may be necessary for
severe disease.
 All individuals with confirmed (or highly
suspected) pertussis should be treated with
antibiotics such as erythromycin, azithromycin
or clarithromycin.
 Supportive care : avoidance of factors that
provoke attacks of coughing, maintenance of
the hydration and nutrition, oxygen if there
is distress, gentle suction for viscid
secretions.

11. ISOLATION
 Patients with suspected pertussis are placed in
respiratory isolation with use of masks by all
health care personnel entering the room.
Screening for cough should be performed and
isolation until 5 days after antibiotic started

12. CAN PERTUSSIS BE
PREVENTED?
 The pertussive vaccine is effective for at least 5
years.

13. Jaundice
• Jaundice, or icterus, is a yellowish discoloration
of the skin, sclera and mucous membranes due
to hyperbilirubinemia, serum bilirubin >2mg/dl).

14. • Sequential sites of jaundice examination
• 1st stage: frenulum of tongue
• 2nd stage: sclera of eye
• 3rd stage: skin

15. • Normal serum bilirubin level is less than 1 mg/dl.

18. Types of jaundice:
1-Prehepatic
2-Hepatic
3-post-hepatic
• 1-Prehepatic jaundice:
• In hemolytic disorders the accompanying anemic
pallor combined with jaundice may produce a
pale lemon complexion. The stools and urine are
normal in color and causes unconjugated
hyperbilirubinemia. Serum liver enzyme
concentrations are normal and jaundice is mild.
•

19. • 2-Hepatic
• hyperbilirubinemia that is both unconjugated
and conjugated. so the urine is dark brown. The
stools are normal in color.
• 3-post-hepatic
• conjugated bilirubin in the bile does not reach
the intestine, so the stools are pale.
• Obstructive jaundice may be accompanied by
pruritus (generalized itch) due to skin deposition
of bile salts.

20. • Thank you