The pertussis-like syndrome can be caused by a range of pathogens in addition to Bordetella pertussis.
Pertussis-like syndrome involves an acute respiratory tract infection with cough for >= 2 weeks and one or more of the following in the absence of a more likely diagnosis:
(1) paroxysms of coughing
(2) inspiratory whoop
(3) post-tussive vomiting
(4) less than 1 year old AND apnea (with or without cyanosis)
Pathogens:
(1) Bordetella pertussis
(2) adenovirus
(3) human metapneumovirus
(4) respiratory syncytial virus (RSV)
(5) influenza virus
(6) parainfluenza virus
(7) Mycoplasma pneumoniae
(8) Chlamydia pneumoniae
Some patients may have more than 1 of these pathogens. Mixed infections may be associated with more severe symptoms and for suboptimal response to therapy.
Because of the spectrum of pathogens and the occurrence of mixed infections the use of molecular respiratory panels are needed for diagnosis.
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