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Vol. 16. Issue 2.
Pages 315-320 (March - April 2010)
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Vol. 16. Issue 2.
Pages 315-320 (March - April 2010)
Caso Clínico/Case Report
Open Access
Pertussis ainda mata
Pertussis keeps on killing
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Joana Freitas1, Susana Gama de Sousa1, Cristina Miguel1, Paula Fonseca1
1 Serviço de Pediatria, CHMA, EPE – Unidade de Famalicão
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Resumo

A tosse convulsa é uma doença respiratória altamente infecciosa e endémica em todo o mundo, causada pela bactéria Bordetella pertussis.

Os autores descrevem o caso clínico de um lactente de 36 dias, admitido no serviço de urgência por dificuldade respiratória e tosse cianosante, internado com suspeita de tosse convulsa complicada por pneumonia bacteriana, tendo iniciado antibioterapia de largo espectro. Apresentava na admissão hiperleucocitose e trombocitose. Foi transferido no segundo dia de internamento para o serviço de cuidados intensivos por agravamento clínico, tendo falecido cerca de 20 horas após admissão por hipertensão e hemorragia pulmonar. A tosse convulsa foi diagnosticada por PCR.

Nos últimos anos, tem-se verificado um aumento do número de casos de tosse convulsa. Os adolescentes e adultos têm-se tornado numa fonte subreconhecida mas significativa de infecção, particularmente para os pequenos lactentes ainda sem a vacinação primária completa.

Os autores salientam a importância do reconhecimento da tosse convulsa, para que, mesmo nos seus quadros mais atípicos, se possa suspeitar, tratar, declarar e prevenir uma doença que não está nem se espera que esteja erradicada a curto ou médio prazo. São necessárias novas estratégias de vacinação para evitar esta doença, que pode ser fatal nos mais vulneráveis.

Rev Port Pneumol 2010; XVI (2): 315-320

Palavras-chave:
Pertussis
tosse convulsa
vacinação
Abstract

Pertussis, or whooping cough, is a highly infectious respiratory disease, endemic all over the world, caused by bacteria Bordetella pertussis.

The authors describe the case of a 36 day old infant, brought to the emergency room due to respiratory distress and cyanosing cough, admitted with suspected pertussis infection complicated by bacterial pneumonia, having begun large spectrum antibiotics. Labs showed hyperleukocytosis and thrombocytosis. She was transferred to an Intensive Care Unit because of a worsened state, dying 20 hours after admission with pulmonary hypertension and haemorrhage. Pertussis was diagnosed by PCR.

Over the last few years, there has been an increase in the number of cases of pertussis. Adolescents and adults have become an under-recognized but significant source of infection, particularly to small unvaccinated infants.

The authors underline the importance of recognizing pertussis, so that even in its atypical presentation, one can suspect, treat, report and prevent a disease that is not, and is not expected to be, eradicated any time soon. New vaccination strategies are necessary, to avoid this disease, which can be fatal to the most vulnerable.

Rev Port Pneumol 2010; XVI (2): 315-320

Key-words:
Pertussis
whooping cough
vaccination
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Bibliografia
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Copyright © 2010. Sociedade Portuguesa de Pneumologia/SPP
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