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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Title
Clinically Diagnosing Pertussis-Associated Cough In Adults And Children
Authoring Organization
American College of Chest Physicians
Publication Month/Year
October 1, 2018
Last Updated Month/Year
January 23, 2024
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