An 8-year-old boy is brought to the physician because of a 7-day history of a progressively worsening cough. The cough occurs in spells and consists of around 5-10 coughs in succession. After each spell, he takes a deep, noisy breath. He has vomited occasionally following a bout of coughing. He had a runny nose for 1 week before the cough started. His immunization records are unavailable. He lives in an apartment with his father, mother, and 2-week-old sister. The mother was given a Tdap vaccination 11 years ago. The father's vaccination records are unavailable. His temperature is 37.8°C (100.0°F). Examination shows no abnormalities. His leukocyte count is 42,000/mm3. Which of the following is the most likely cause of this patient's symptoms?

Question

Quizplus · Accepted Answer

Eductional Objective: Pertussis should be considered in any adult who has not had updated vaccination boosters.  The clinical presentation is a paroxysmal cough lasting >2 weeks that is associated with post-tussive emesis or inspiratory whoop after a severe coughing episode.

An 8-Year-Old Boy Is Brought to the Physician Because of a 7-Day