PED3 Subdural fluid collection due to pertussis. (Pediatrics and Adolescent Medicine).PED3 SUBDURAL subdural /sub·du·ral/ (-door´al) between the dura mater and the arachnoid. sub·dur·al adj. Located or occurring beneath the dura mater. FLUID COLLECTION DUE TO PERTUSSIS. Antonio E. Muniz, MD. Department of Emergency Medicine and Pediatrics, Medical College of Virginia of VCU, Richmond. Pertussis is an acute respiratory illness that begins with mild upper respiratory tract infection upper respiratory tract infection URI Infectious disease A nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, and larynx, the prototypic URI is the common cold; flu/influenza is a systemic illness involving the URT that can progress to severe paroxysms of cough, often with a characteristic inspiratory whoop followed by posttussive vomiting. It also has been shown to have some important complications. An 11-week-old boy was brought to the ED with a cough, increasing apnea, and bradycardias. He was born at 32 weeks' gestation and diagnosed with apnea of prematurity. There was no fever, vomiting, or diarrhea. He had a temperature of 37.8[degrees]C, heart rate 150/min, and respiratory rate 44/min His physical examination was unremarkable. His WBC was 9,500/[mm.sup.3] with 77% neutrophils. His hemoglobin was 10.6 g/dL and platelets 195,000/[mm.sup.3]. His electrolytes were normal. His chest radiograph was normal. He was admitted for observation. During his hospitalization, he had a tonic event with his eyes deviated upward. He had a normal EEG. His CT revealed bilateral frontal subdural hematomas. He had a normal esophagram. A d irect immunofluorescent assay for Bordetella pertussis was positive. He was started on erythromycin and was discharged home without any complications. Pertussis is caused by B pertussis, less frequently by Bordetella Bordetella A genus of gram-negative bacteria which are coccobacilli and obligate aerobes, and fail to ferment carbohydrates. These bacteria are respiratory pathogens. Bordetella pertussis, B. parapertussis, and B. para-pertussis. It is a disorder characterized by three stages: catarrhal, paroxysmal, and convalescent. Complications are common and are grouped into respiratory, central nervous system (CNS), and secondary pressure effects. Respiratory complications include pneumonia, atelectasis atelectasis or lung collapse Lack of expansion of pulmonary alveoli (see pulmonary alveolus). With a large-enough collapsed area, the victim stops breathing. , bronchiectasis bronchiectasis Abnormal expansion of bronchi in the lungs. It usually results when preexisting lung disease causes bronchial inflammation and obstruction. Bronchial wall fibres degenerate, and bronchi become dilated or paralyzed, preventing removal of secretions, which , emphysema, or pneumothorax pneumothorax (n  mōthôr`ăks), collapse of a lung with escape of air into the pleural cavity between the lung and the chest wall. The cause may be traumatic (e.g. . CNS
effects may include seizures or encephalopathy. Secondary pressure
effects during the paroxysmal stage may cause epistaxis, melena,
petechiae PetechiaeTiny purple or red spots on the skin associated with endocarditis, resulting from hemorrhages under the skin's surface. Mentioned in: Endocarditis, Hantavirus Infections, Hemorrhagic Fevers, Idiopathic Thrombocytopenic Purpura , subconjunctival hemorrhages, subdural hematoma, umbilical or inguinal hernias, and rectal prolapse. |
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