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  1. Organism
    • Gram negative coccobacillus
    • Special media = NAD and charcoal
    • Slow growing, 3-5 days
    • Survives briefly outside of RT
    • FHA = strang adherance qualities
    • Pili and pertactin (PRN)
  2. Toxins
    • Pertussis toxin: A-B toxin, ADP-R Gi protein, which inhibitis it, increase cAMP
    • Adenylate cyclase (ACT): catalyzes conversion of ATP to cAMP; hemolytic and interferes with cell signalling and microbicidal function of PMNs and Monos
    • Tracheal cytotoxin: fragments of cell wall peptidoglycan; cause death of ciliated tracheal cells
  3. Epidemiology
    • Airborne droplets in early stages of disease
    • highly contagious
    • Strict human disease
    • Previously immunized adults are revervoirs
    • Mortality high in infants
  4. Pathogenesis
    • Tropism for ciliated epithelium cells
    • Adherance mediated bu FHA< pili, pertactin and PT
    • Adherance leads to destruction of ciliated cells, cause by tracheal toxin
    • Loss of mucus escalator -> cough
    • Non-invasive
    • PT and ACT causes PMN, Mac and lymphocyte paralysis and death
    • PT=lymphocytosis, histamin secretion, insulin secretion
    • Immunity: IgG against PT, pili, Pertactin, wanes with age
  5. Manifestations
    • 7-10 days
    • Catarrhal: profuse mucoid rhinorrhea for 1-2 weeks with non-specific findings; most communicable at this stage
    • Paroxysmal stage: starts with cough, up to 50x a day for 2-4 weeks; whoop and vomiting may cause apnea; marked lymphocytosis (up to 40,000)
    • Convalescent stage: coughing, other features fade
  6. Diagnosis
    • Clinical
    • Confirmed by isolation from nasal secretions
    • Special media - 3-7 days
    • DFA for rapid diagnosis
    • PCR
  7. Treatment
    • Supportive
    • Antmicrobial at early stages
    • Prevention: active immunization
Card Set:
2011-11-18 03:35:08

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