Clinical features and prognosis of ınfants hospitalized with pertussis

Amaç: Boğmaca tanısı ile yatırılarak izlenmiş bebekle- rin klinik tablo ve prognozlarının değerlendirilmesi. Gereç ve Yöntemler: Hastanemiz Çocuk Enfeksiyon Hastalıkları Bilim Dalı’nda Mart 2008-Mart 2012 tarihleri arasında boğmaca tanısı ile yatırılarak izlenen hastalar retrospektif olarak değerlendirildi. Boğmaca tanımlama- sı için Dünya Sağlık Örgütü'nün sınıflaması kullanıldı. Bulgular: Toplam 40 olgu boğmaca tanısı ile izlendi. Hastaların 28’si kız, 12’si erkekti. Ortanca yaşı 1,9 (minimum-maksimum=0,8-4) aydı. Başvuru öncesi öksürük süresi ortanca 15 (minimum- maksimum=2-18) gündü. Olguların 17’si (%42) yaz mevsiminde başvur- muştu. Hastaların %45’inde aile de öksüren birey bulunuyordu. Vakaların %80’i aşısızdı, %20’sine tek doz aşı uygulanmıştı. Vakaların hepsinde nöbetler halinde gelen boğulur tarzda öksürük, 3 vakada (%7,5) ateş, 5 vakada (%12,5) akciğerde ral ve 4 vakada (%10) solunum sıkıntısı vardı. Başvuru anında labora- tuar bulgularında ortanca beyaz küre sayısı: 14400 (minimum-maksimum=5420-106000)/mm3, hemoglo- bin: 11,5 (minimum-maksimum=8-17)gr/dL, trombosit sayısı 417000 (minimum-maksimum=150000-784000)/ mm3 idi. Boğmaca tanısı 6 vakada (%15) kültür ve polimeraz zincir reaksiyonu ile tanımlandı. İki olgu (%5) yoğun bakım servisinde izlendi, mekanik ventilatör desteği aldı ve bu hastalar multiorgan yetmezliği ile kaybedildi. Ortanca hastanede yatış süresi 7 (mini- mum-maksimum=1-17) gündü. Sonuç: Yüksek aşılanma oranlarına rağmen boğmaca halen dünyada olduğu gibi ülkemizde de önemli bir sorundur. Özellikle henüz aşılanmamış ya da aşıları tamamlanmamış küçük bebeklerde uzun süreli hasta- nede yatışlara, komplikasyonlara ve mortaliteye neden olabilmektedir. Ülkemizde de adölesan ve erişkinlerin aşılanması hastalığın ağır seyrettiği küçük bebeklerin korunması açısından önemlidir. (J Pediatr Inf 2013; 7: 47-52)

Boğmaca nedeni ile hastaneye yatan süt çocuklarında klinik tablo ve prognoz

Objective: To evaluate clinical status and prognosis of hospitalized infants with pertussis. Material and Methods: Hospitalized patients diag- nosed with pertussis from March 2008 to March 2012 at the Department of Paediatric Infectious Diseases were assessed retrospectively. The WHO (World Health Organization) for the definition of pertussis was used. Results: During the study period 40 children (28 girls, 12 boys) with pertussis were evaluated. The median age was 1.9 (range 0.8-4) months. The median cough period until the application was 15 (range 2-18) days. Seventeen cases (42%) were admitted during the summer season; 45% of patients had a family mem- ber with a cough; 80% of cases were unvaccinated and 20% had been vaccinated only once. Coughing attacks were seen in all cases, fever in 2 (5%) cases, auscultatory crackles in 12 (30%) cases and difficulty breathing in 4 (10%) cases. At admission, the median values of laboratory tests were as follows: WBC count: 14400/mm3 (range 5420-106000), Hb: 11.5 g/ dL (range 8-17), Plt: 417000/mm (range 150000- 784000). Pertussis was confirmed in six cases (15%) by culture and PCR. Two cases (2%) were admitted to the intensive care unit for mechanical ventilation support and these patients died due to multiorgan failure. The median length of hospitalization was 7 (range 1-17) days. Conclusion: Despite high rates of pertussis vaccina- tion, pertussis remains an important problem in Turkey, as well as world wide. Pertussis causes long- term hospitalization, complications and mortality, especially in young children who have not been vac- cinated or were vaccinated incompletely. In Turkey, it is important to vaccinate adolescents and adults to protect young babies with severe trend. (J Pediatr Inf 2013; 7: 47-52)

Kaynakça

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