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05 Jul 2005

Hi, I think my daugter has whooping cough, what is the symtoms, and what medicine to treat it ?.
Answer 400 views

01 Jan 0001

Liesl, the catarrhal stage begins insidiously, generally with sneezing, lacrimation, or other signs of coryza; anorexia; listlessness; and a troublesome, hacking nocturnal cough that gradually becomes diurnal. Fever is rare.
The paroxysmal stage occurs after 10 to 14 days when the cough increases in severity and number. Five to 15 or more rapidly consecutive forceful coughs occur during a single expiration and are followed by the whoop, a hurried, deep inspiration. After a few normal breaths, another paroxysm may begin. Copious amounts of viscid mucus may be expelled (usually swallowed by infants and children but also producing large bubbles via the nares) during or after the paroxysms. Vomiting subsequent to paroxysms or due to gagging on the tenacious mucus is characteristic. In infants, choking spells (with or without cyanosis) may be more common than whoops.
The convalescent stage usually begins within 4 wk; paroxysms are not so frequent or severe, vomiting decreases, and the patient looks and feels better. Average duration of illness is about 7 wk (range, 3 wk to 3 mo). Paroxysmal coughing may recur for months, usually induced by irritation from an upper respiratory tract infection.
Hospitalization is recommended for seriously ill infants to assess progression of disease and prevent and treat complications. Small frequent meals are advisable. Parenteral fluid therapy may be required to replace sodium and water losses if vomiting is severe. In infants, suction to remove excess mucus from the throat may be lifesaving, and tracheostomy or nasotracheal intubation is occasionally needed. O2 should be given if cyanosis persists after removal of mucus. Because any disturbance can precipitate serious paroxysmal spells with anoxia, seriously ill infants should be kept in a darkened, quiet room and disturbed as little as possible. Close attention should be paid to the nutritional needs of the infant, since preexisting or developing malnutrition can adversely affect outcome.
Expectorant cough mixtures, cough suppressants, and mild sedation are of questionable value and should be used cautiously or not at all. Drugs such as theophylline or albuterol and corticosteroids have also been suggested for the treatment of severely ill patients; however, further controlled studies are needed to assess their effectiveness and potential hazards. Antibiotics given in the catarrhal stage may ameliorate the disease. After paroxysms are established, antibiotics usually have no discernible effect but are recommended to limit spread. The drug of choice is erythromycin 40 to 50 mg/kg po q 6 h for 14 days. Antibiotics should also be used for any bacterial complications such as bronchopneumonia and otitis media. Bed rest is unnecessary for older children with mild disease.
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