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

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 clin ician 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 a fter 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 c onfirm the diagnosis (PCR for a vaccinated adult, serology by immunoprint) and to discuss an adequate antibiotic therapy (macrolides). (C) 2001 Editio ns scientifiques et medicales Elsevier SAS.