Clinical Retrospective Analysis Of Children With Pertussis

Objective:Through the clinical retrospective analysis of 116 cases of children with whooping cough(including 52 outpatients and 64 inpatients)confirmed by polymerase chain reaction(PCR)detection in hebei provincial people's hospital on July 1,2017 and January 31,2019,the clinical characteristics,auxiliary examinations and clinical characteristics of whooping cough were analyzed.It provides some reference for the early and rapid diagnosis of pertussis.Methods:116cases(including 52 outpatients and 64 inpatients)with whooping cough confirmed by bacterial polymerase chain reaction(PCR)in hebei provincial people's hospital on January 31,2019 were collected and analyzed retrospectively.All data were statistically processed by SPSS21 and excel.Results: Among the 116 cases collected in this paper,the incidence in the fourth quarter of 2018 was 11 cases in spring,52 cases in summer,20 cases in autumn and 16 cases in winter.Summer 2017:8 cases,autumn: 2 cases,winter: 7 cases.Among them,age <= 3 months,44 cases,ataccounting for 38% of the total children;Over 3 months,64 cases,accounting for 62% of the total children.There were 52 cases of children not immunized(including children not vaccinated or not fully vaccinated),accounting for about 45% of the total children,and 64 cases of children immunized,accounting for 55% of the total children.Common clinical manifestations of pertussis: 108 cases of children with paroxysmal spastic cough,accounting for 93% of the total children;There were 56 cases of children with coda of chicken crow,accounting for 48% of the total children.There were 40 cases of children with flushing in cough,accounting for 34% of the total.There were36 cases of cyanosis,accounting for 31% of all cases.There were 16 cases of fever,accounting for 13% and 32 cases of nasal wing agitation,accounting for 27%.There were16 children with positive tri-concave sign,accounting for 13% of the total children.Fifteen cases(51%)had rough breath sounds in both lungs.Lung auscultation was performed in 24 cases,accounting for 20% of the total.There were 20 cases of wheezing sound,accounting for 17% of the total children.Among the 64 hospitalized children,peripheral blood routine examination in laboratory examination indicated that the white blood cell count was increased in 48 children,accounting for 75% of the total children.There were 20 normal children,accounting for 25% of the total children,and 48 children,accounting for 60% of the total children,accounting for 75%.<60% 16 cases,accounting for 25% of the total children.Peripheral blood routine examination indicated that the white blood cell count was increased and the lymphocyte percentage was 60% of > in 32 children,accounting for 50% of the total children.Elevated white blood cell count and lymphocyte percentage < 60% children with 16 cases,account for about 25% of children with white blood cell count between 10 ^ 9 / L(7.1 ~ 35.88),with an average of 15.08 10 ^ 9 7.43 / L.Among the 64 hospitalized children without complicated by other secondary infections,chest imaging showed pertussis with cumulative lower respiratory tract infection,and lung imaging showed increased fuzzy lung texture and no significant difference in the number of cases of bronchitis and pneumonia.Conclusion:1.Sporadic cases of pertussis occur throughout the year,mostly in summer.Unlike previous reports,the incidence of pertussis is higher in urban areas than in rural areas.2.The proportion of children who have not been vaccinated(including those who have not been fully immunized with 3 doses)and those who have not reached the age of vaccination are few,Immunised children have less clinical manifestations than non-immunised children.3.In hospitalized children,the peripheral blood routine examination mostly indicated that the white blood cell count was increased,and the lymphocyte percentage was the main classification.However,the blood routine of immunized children suggested that the white blood cell count could be normal.4.Chest imaging mostly showed lung texture changes and bronchitis,no obvious consolidation of the disease.If pulmonary consolidation occurs,clinical consideration should be given to the presence of secondary infections such as streptococcus pneumoniae and mycoplasma pneumoniae.5.For children with chronic paroxysmal cough,PCR can help to identify the presence of pertussis bacillus infection.