Clinical presentations of whooping cough in the adult: when should they be considered?

Clinical presentations of whooping cough in the adult: when should they be considered? Recent studies have shown that the prevalence of whooping cough is from 10-20% in adult patients who have a persistent cough for more than a week but not longer than two months. Faced with this very ordinary symptom, the clinician must consider whooping cough and try to support this diagnosis by the five key elements: 1) the paroxysmal and asthenic nature of the cough; 2) the particular course of the symptoms, where the cough becomes aggravated after an initial catarrhal stage; 3) the normal physical examination between coughing attacks; 4) the identification of a possible contaminating agent in the family circle; and 5) a normal chest X-ray. A strengthened clinical suspicion should lead the clinician to request biological tests likely to confirm the diagnosis (PCR for a vaccinated adult, serology by immunoprint) and to discuss an adequate antibiotic therapy (macrolides). (C) 2001 Editions scientifiques et medicales Elsevier SAS.