Clinically Diagnosing Pertussis-Associated Cough In Adults And Children

Publication Date: October 1, 2018
Last Updated: March 14, 2022

Recommendations

1. For adult patients complaining of acute cough (< 3 weeks in duration) or subacute cough (3-8 weeks), we suggest that clinicians should specifically assess for the 4 key characteristics of paroxysmal cough, post-tussive vomiting, inspiratory whooping, and absence of fever in ruling in or out a clinical diagnosis of pertussis. (2C)
Remark: Paroxysmal cough is defined as recurrent prolonged coughing episodes (ie, an expiratory phase with multiple burst of outflow) with an inability to breathe during spells. Posttussive vomiting is defined as vomiting induced by coughing. Inspiratory whooping is defined as a continuous inspiratory airway sound with a whooping quality to it. Fever is defined as any body temperature above the normal of 98.6°F (37°C).
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2. For adult patients complaining of acute or subacute cough, we suggest that clinicians consider that the cough is unlikely to be due to pertussis if the patient has a fever or the cough is not paroxysmal in nature. (2C)
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3. For adult patients complaining of acute or subacute cough, we suggest that clinicians consider that the cough is likely to be caused by pertussis if there is posttussive vomiting or is associated with an inspiratory whooping sound. (2C)
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4. For children complaining of acute cough (< 4 weeks in duration), we suggest that clinicians should specifically assess for the 3 classical characteristics of paroxysmal cough, posttussive vomiting, and inspiratory whooping. (U-CBS)
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5. For children complaining of acute cough, we suggest that clinicians consider that the cough could be caused by pertussis if there is posttussive vomiting. (2C)
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6. For children complaining of acute cough, we suggest that clinicians consider that the cough could be caused by pertussis if there is paroxysmal cough or inspiratory whooping. (U-CBS)
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Recommendation Grading

Disclaimer

Overview

Title

Clinically Diagnosing Pertussis-Associated Cough In Adults And Children

Authoring Organization

Publication Month/Year

October 1, 2018

Last Updated Month/Year

July 5, 2022

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than waiting for laboratory confirmation. The current guideline focuses on making the clinical diagnosis of pertussis-associated cough in adults and children.

Target Patient Population

Adults and children with cough

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Childcare center, Outpatient, School

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Management

Diseases/Conditions (MeSH)

D003371 - Cough, D037342 - Pertussis Toxin, D014917 - Whooping Cough

Keywords

diagnosis, antibiotic, cough, acute cough, pertussis, whooping cough