178.4 📌 章末速蚘

  • B. pertussis — gram - coccobacillus, Bordet-Gengou + NAD-dependent
  • PT toxin + ACT + TCT + FHA + pertactin (PRN-deficient escape)
  • 3 phases: catarrhal → paroxysmal (whoop) → convalescent (100-day cough)
  • 嬰兒 < 6 mo: no whoop, apnea, cyanosis → high mortality
  • Treatment: azithromycin 5d (preferred); erythromycin avoided neonates
  • TMP-SMX alt
  • Prevention: DTaP infant + Tdap 11-12 + 1 adult + 每次 pregnancy 27-36 wk + cocooning
  • Contact prophylaxis: azithromycin × 5d within 21 days
  • 2024 global resurgence (USA, China, EU)
  • Lymphocytosis > 10K in pediatric — clue