178.2 📚 國考版

178.2.0.1 必背 — Bacteriology

• Gram - coccobacillus
• Bordet-Gengou / Regan-Lowe
• NAD-dependent

178.2.0.2 必背 — Toxins

• Pertussis toxin (PT) — AB5, ADP-ribosylate Gi → lymphocytosis
• ACT, TCT, FHA, pertactin

178.2.0.3 必背 — 3 Phases

• Catarrhal (URI-like, most contagious)
• Paroxysmal (cough + whoop + post-tussive emesis)
• Convalescent (“100-day cough”)

178.2.0.4 必背 — Infant Atypical

• No whoop, apnea, cyanosis, gasping
• High mortality
• Pulmonary HTN, encephalopathy

178.2.0.5 必背 — Treatment

• Azithromycin 5d (preferred all ages)
• Erythromycin avoided neonates (pyloric stenosis risk)
• TMP-SMX alt

178.2.0.6 必背 — Prevention

• DTaP infant series + 4-6 yr booster
• Tdap 11-12 yr + 1 adulthood + 每次 pregnancy 27-36 wk
• Contact prophylaxis: azithromycin × 5d within 21 days

178.2.0.7 必背 — Lymphocytosis Clue

• 10,000-20,000 lymph in pediatric — classic

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