The role of culture as the goal standard in diagnosing pertussis
has come into question as other tests such as serology and polymerase
chain reaction have proven to be both more specific and sensitive.2
Specimen collection from the nasopharynx appears to be more appropriate
than from the throat.3
Lymphocytosis > 50 % was observed in all patients. Lymphocytosis
> 70% was observed in 47% of 30 patients studied with documented
pertussis infection. Thus, this finding remains important
95% of patients had a cough - only 16% of patients had the characteristic
'whoop' associated with the cough. It usually occurres late in the
clinical course, making this less useful in deciding whom to test.
of patients with documented pertussis infections were hospitalized.
Out of the 38 patients, complications included 6 cases of OM, 3 cases
of pneumonia and 1 case of apnea requiring mechanical ventilation.
PH. Fisher MC. Importance of Culture in Laboratory diagnosis
of Bordetella pertussis infections. Journal of Clin Microbiology.
vanderZee A. Agterberg C. Peeters M. A clinical validation of
B. pertussis and B. parapertussis polymerase chain reaction: comparison
with culture and serology using samples from patients with suspected
whooping cough from a highly immunized population. Journal of Infectious
Diseases. 174(1):89-96, 1996.
Marcon, MJ. Hamoudi AC. Comparisons of throat and nasopharyngeal
swab specimens for culture diagnosis of Bordetella pertussis
infection. Journal of Clinical Microbiology.
L. Hayden GF. Pertussis in primary care practice. Primary
Care Clinics in Office Practice vol 23, number 4