- Pertussis
- Tetanus
- Pertussis & Tetanus
- ملاحظات لمحاضرة الperussis
- ملاحظات لمحاضرة ال tetenus
- تفريغ 2025 tetanusDR☆
- تفريغ محاضرة ال pertussis كاملة
- تفريغ المحاضرة كاملةTetanus+pertussis
🌸written for pertussis:
1-clinical stages
2-complication
3-age related presentation
4-investigations
5-TTT
6-vaccination
باقي محاضرة الpertussis (mcq)
🌸🌸🌸
🌸Written for tetanus:
1-clinical manifestation
2-treatment
3-wound prophylaxis
🌸MCQ :
ال toxin
اسمه tetanospasmin
+فيه ٢ cases في بداية الباور
ليهمD.D:
1-pneumonia
2-bronchitis
3-T.B
4-pertussis
5-common cold
6-influanza
🌸 Pertussis (Whooping Cough)
1. Clinical Stages
- Incubation (5–21 days): Asymptomatic; typically lasts ~7–10 days.
- Catarrhal Stage (1–2 weeks): Nonspecific URI symptoms (mild cough, coryza, sneezing, low fever) and is highly infectious.
- Paroxysmal Stage (2–6+ weeks): Classic repetitive coughing fits ending in a high-pitched “whoop” on inspiration. Attacks can cause facial reddening, cyanosis, bulging eyes, tongue protrusion, and post-tussive vomiting.
- Convalescent Stage (2+ weeks): Gradual improvement where cough lessens in frequency and severity, though paroxysms may recur with future respiratory infections.
2. Complications
- Infants: Highest morbidity, including apnea, cyanotic spells, pneumonitis (>10%), pulmonary hypertension, seizures, and encephalopathy. Subdural hemorrhage and death are the most severe outcomes.
- Children/Adolescents: Pneumonia (bacterial superinfection), otitis media, and rarely rib fractures from violent coughing.
- General: Hernias (umbilical, inguinal) or rectal prolapse from straining, subconjunctival hemorrhages, weight loss, and dehydration.
3. Age-Related Presentation
- Infants (<1 year): Often no obvious whoop; instead present with apnea, bradycardia, and cyanosis during coughing spells. May have poor feeding and irritability.
- Children (1–10 years): Classic presentation with loud whoop, choking spells, and post-tussive vomiting.
- Adolescents/Adults: Often present with a prolonged cough without a whoop and is less severe.
4. Investigations
- Laboratory: Marked leukocytosis with lymphocytosis is suggestive (often >50% lymphocytes, WBC >20,000) .
- Microbiology: Confirm with PCR (preferred) or culture of nasopharyngeal specimens on special Bordetella media, optimally within the first 2–3 weeks of cough.
5. Treatment (TTT)
- Antibiotics: Azithromycin is first-line (5-day course) for infants ≥1 month and contacts. Erythromycin or clarithromycin can be used for 7–10 days, and TMP-SMX is used if macrolides are contraindicated or the patient is ≥2 months.
- Supportive Care: Hospitalize high-risk patients (infants, respiratory distress). Maintain hydration/nutrition, provide oxygen, and suction secretions if needed. Cough suppressants are not recommended in infants.
- Infection Control: Isolate the patient (droplet precautions) until 5 days of therapy.
6. Vaccination
- DPT: Routine for infants/children <7 years, given as a 5-dose series at 2, 4, 6, 15–18 months, and 4–6 years.
- Tdap: One booster at 11–12 years. Given during each pregnancy (27–36 weeks) to protect the newborn. Adults who never had Tdap should get one dose.
🌸 Tetanus
1. Clinical Manifestation
- Incubation period: 3–14 days.
- Earliest sign: Feeding difficulty due to trismus (lockjaw).
- Progression: Rigidity spreads to the neck, back, and limbs, leading to a fisting posture.
- Spasms: Painful, stimulus-triggered spasms with preserved consciousness.
- Characteristic signs: Risus sardonicus (grimace-like smile with clenched jaw) and Opisthotonus (severe back arching).
2. Treatment
- Control of spasms: Diazepam or phenobarbitone in a quiet environment.
- Neutralize toxin: Human Tetanus Immunoglobulin (HTIG) 500 units IM, or Antitetanic Serum (ATS) 5000 units IM.
- Eradicate bacteria: Penicillin or metronidazole along with wound/umbilical care.
- Supportive care: ICU management, airway maintenance, hydration, and gavage feeding.
3. Wound Prophylaxis
- Clean all wounds.
- Give ATS (3000 units IM) for dirty/deep wounds.
- TT booster based on vaccination status: No booster needed if vaccinated <5 years ago; give a booster if >5 years ago; give a full 3-dose series if unvaccinated.
🌸written for pertussis:
1-clinical stages
2-complication
3-age related presentation
4-investigations
5-TTT
6-vaccination
باقي محاضرة الpertussis (mcq)
🌸🌸🌸
🌸Written for tetanus:
1-clinical manifestation
2-treatment
3-wound prophylaxis
🌸MCQ :
ال toxin
اسمه tetanospasmin
+فيه ٢ cases في بداية الباور
ليهمD.D:
1-pneumonia
2-bronchitis
3-T.B
4-pertussis
5-common cold
6-influanza
🌸 Pertussis (Whooping Cough)
1. Clinical Stages
- Incubation (5–21 days): Asymptomatic; typically lasts ~7–10 days.
- Catarrhal Stage (1–2 weeks): Nonspecific URI symptoms (mild cough, coryza, sneezing, low fever) and is highly infectious.
- Paroxysmal Stage (2–6+ weeks): Classic repetitive coughing fits ending in a high-pitched “whoop” on inspiration. Attacks can cause facial reddening, cyanosis, bulging eyes, tongue protrusion, and post-tussive vomiting.
- Convalescent Stage (2+ weeks): Gradual improvement where cough lessens in frequency and severity, though paroxysms may recur with future respiratory infections.
2. Complications
- Infants: Highest morbidity, including apnea, cyanotic spells, pneumonitis (>10%), pulmonary hypertension, seizures, and encephalopathy. Subdural hemorrhage and death are the most severe outcomes.
- Children/Adolescents: Pneumonia (bacterial superinfection), otitis media, and rarely rib fractures from violent coughing.
- General: Hernias (umbilical, inguinal) or rectal prolapse from straining, subconjunctival hemorrhages, weight loss, and dehydration.
3. Age-Related Presentation
- Infants (<1 year): Often no obvious whoop; instead present with apnea, bradycardia, and cyanosis during coughing spells. May have poor feeding and irritability.
- Children (1–10 years): Classic presentation with loud whoop, choking spells, and post-tussive vomiting.
- Adolescents/Adults: Often present with a prolonged cough without a whoop and is less severe.
4. Investigations
- Laboratory: Marked leukocytosis with lymphocytosis is suggestive (often >50% lymphocytes, WBC >20,000) .
- Microbiology: Confirm with PCR (preferred) or culture of nasopharyngeal specimens on special Bordetella media, optimally within the first 2–3 weeks of cough.
5. Treatment (TTT)
- Antibiotics: Azithromycin is first-line (5-day course) for infants ≥1 month and contacts. Erythromycin or clarithromycin can be used for 7–10 days, and TMP-SMX is used if macrolides are contraindicated or the patient is ≥2 months.
- Supportive Care: Hospitalize high-risk patients (infants, respiratory distress). Maintain hydration/nutrition, provide oxygen, and suction secretions if needed. Cough suppressants are not recommended in infants.
- Infection Control: Isolate the patient (droplet precautions) until 5 days of therapy.
6. Vaccination
- DPT: Routine for infants/children <7 years, given as a 5-dose series at 2, 4, 6, 15–18 months, and 4–6 years.
- Tdap: One booster at 11–12 years. Given during each pregnancy (27–36 weeks) to protect the newborn. Adults who never had Tdap should get one dose.
🌸 Tetanus
1. Clinical Manifestation
- Incubation period: 3–14 days.
- Earliest sign: Feeding difficulty due to trismus (lockjaw).
- Progression: Rigidity spreads to the neck, back, and limbs, leading to a fisting posture.
- Spasms: Painful, stimulus-triggered spasms with preserved consciousness.
- Characteristic signs: Risus sardonicus (grimace-like smile with clenched jaw) and Opisthotonus (severe back arching).
2. Treatment
- Control of spasms: Diazepam or phenobarbitone in a quiet environment.
- Neutralize toxin: Human Tetanus Immunoglobulin (HTIG) 500 units IM, or Antitetanic Serum (ATS) 5000 units IM.
- Eradicate bacteria: Penicillin or metronidazole along with wound/umbilical care.
- Supportive care: ICU management, airway maintenance, hydration, and gavage feeding.
3. Wound Prophylaxis
- Clean all wounds.
- Give ATS (3000 units IM) for dirty/deep wounds.
- TT booster based on vaccination status: No booster needed if vaccinated <5 years ago; give a booster if >5 years ago; give a full 3-dose series if unvaccinated.