Pneumomediastinum as a complication of critical pertussis

Monaco, Francesco; Barone, Mario; Manfredi, Valeria Graziella Laura; Marando, Rosario; Nunnari, F; David, Antonio; Monaco, Maurizio

doi:10.1111/crj.12285

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…Older adults with pertussis have also had uncommon nonrespiratory complications, including encephalopathy, intracranial hemorrhage, stroke, carotid artery dissection, pneumomediastinum, and herniated lumbar discs (313,326,330,331).…”

Section: Complications Of Pertussis In Infants Children and Adultsmentioning

confidence: 99%

Pertussis: Microbiology, Disease, Treatment, and Prevention

et al. 2016

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SUMMARYPertussis is a severe respiratory infection caused byBordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution ofB. pertussisstrains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmitB. pertussisto younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding ofB. pertussispathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines.

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Section: Complications Of Pertussis In Infants Children and Adultsmentioning

confidence: 99%

Pertussis: Microbiology, Disease, Treatment, and Prevention

et al. 2016

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“…Alveolar over‐inflation with subsequent alveolar over‐inflation and rupture with consecutive transfer of air along the bronchi into the mediastinum has been identified as primary mechanism . As such, increased intra‐alveolar pressure (relative to the interstitium surrounding peripheral alveoli), during coughing, vomiting, and cocaine sniffing, and barotrauma during diving or gas inhalation present characteristic triggers of SPM . Similarly, activities associated with alveolar over‐inflation such as pronounced physical activity have been associated with SPM .…”

Section: Discussionmentioning

confidence: 99%

Mediastinal emphysema after long‐distance flight with ketoacidosis and underlying diabetes mellitus type 1

Pardo

Kübler

Witzenrath

et al. 2019

Respirology Case Reports

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A 21‐year old female with diabetes mellitus type 1 presented to our hospital's emergency department having suffered from shortness of breath, mild chest pain, and vomiting following her arrival after a long‐distance flight two days earlier. Symptoms had since subsided and physical examination was normal. Blood analysis revealed increased D‐dimers and diabetic ketoacidosis. Computed tomography (CT) examination excluded pulmonary embolism but demonstrated significant mediastinal emphysema. After conservative treatment including nasal oxygen and adjustment of insulin therapy, follow‐up low‐dose CT after four days confirmed full regression of the emphysema. The patient was discharged feeling well, with a recommendation for improved diabetes treatment. Spontaneous pneumomediastinum is a rare condition occurring in younger patients without trauma or pulmonary disease. Over‐inflation and/or pulmonary vasoconstriction have been proposed as major physiological contributors and were likely evoked in the present case by increased respiratory drive due to ketoacidosis and hypoxic vasoconstriction during long distance flight.

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“… 2 This leads to the development of a characteristic severe spasmodic cough associated with a high-pitched inspiratory ‘whoop’. 3 Most pertussis-related deaths are associated with bacterial pneumonia as a secondary complication. 3 …”

Section: Introductionmentioning

confidence: 99%

“… 3 Most pertussis-related deaths are associated with bacterial pneumonia as a secondary complication. 3 …”

Section: Introductionmentioning

confidence: 99%

Adverse events following primary and secondary immunisation with whole-cell pertussis: a systematic review protocol

et al. 2017

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IntroductionPertussis is a contagious respiratory illness caused by the bacterium Bordetella pertussis. Two types of vaccines are currently available against the disease: whole-cell pertussis (wP) and acellular pertussis (aP). With the shift of high-income countries from wP to aP as a result of adverse events following immunisation (AEFI), an upsurge in reported cases of pertussis has been noticed. Owing to this, it is proposed to use wP as a prime and aP for boost vaccination strategy. However, a comparison of the AEFI with the first doses of wP and aP are not clearly documented.Methods and analysisThe primary outcomes of interest are AEFI with dose 1 of wP, subsequent doses of wP and dose 1 of aP. As a secondary outcome frequency of AEFI with wP will be compared with the AEFI of doses 2 and 3 of wP and dose 1 of aP. Electronic databases will be searched and two authors will screen the titles and abstracts of the output. Full texts will then be independently reviewed by the first author and two other authors. Qualifying studies will then be formally assessed for quality and risk of bias using a scoring tool. Following standardised data extraction, statistical analysis will be carried out using STATA. Where data are available, subgroup analyses will be performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be followed in reporting the findings of the systematic review and meta-analysis.Ethics and disseminationNo ethics approval is required as the systematic review will use only published data already in the public domain. Findings will be disseminated through publication in a peer-reviewed journal.Trial registration numberThis protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016035809.

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Pneumomediastinum as a complication of critical pertussis

Abstract: Pneumomediastinum and subcutaneous emphysema have never been described in adult patients with pertussis. Physicians should be aware that patients presenting with persistent cough and pneumomediastinum may have pertussis and include this in their differential diagnosis.

Cited by 8 publications

References 24 publications

Pertussis: Microbiology, Disease, Treatment, and Prevention

Pertussis: Microbiology, Disease, Treatment, and Prevention

Mediastinal emphysema after long‐distance flight with ketoacidosis and underlying diabetes mellitus type 1

Adverse events following primary and secondary immunisation with whole-cell pertussis: a systematic review protocol

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