Respiratory Case Study: Possible Pertussis Infection

Respiratory Case Study: Possible Pertussis Infection is organized by MediaLab, Inc.

Description:
This course describes the clinical symptoms of Bordetella pertussis infection. Proper specimen collection and transport for diagnosis of B. pertussis along with laboratory testing procedures that aid in its diagnosis are presented. Advantages and disadvantages for each testing procedure including culture, nucleic acid amplification testing (NAAT), direct fluorescent antibody staining, and serology are discussed. Treatment options for pertussis infection including available vaccines are presented in this course.

Objectives:
• Identify the clinical symptoms of Bordetella pertussis infection.
• Describe proper specimen collection and transport for diagnosis of B. pertussis.
• Identify laboratory testing procedures that aid in the diagnosis of B. pertussis.
• Discuss advantages and disadvantages for each testing procedure including culture, nucleic acid amplification testing (NAAT), direct fluorescent antibody staining, and serology.
• Explain the principles of NAAT testing for B. pertussis.
• Discuss treatment options for pertussis infection.
• Identify available vaccines that can help to prevent infection with B. pertussis. 

Course Outline:
• Case Presentation
    • Case Study
    • Pathogenesis and Virulence Factors
    • Epidemiology and Transmission
    • Clinical Course and Significance of the Disease
    • Table 1: Stages and Clinical Features of Pertussis
    • Complications
    • Case Study, continuedThe clinician calls the laboratory to obtain instructions for the collection of the specimen. Which of these specimens and collec...
    • Proper Specimen Collection and Transport
• Laboratory Workup
    • Identification by Culture Methods
    • Case Study, continued: Laboratory Testing
    • Case study, continued Upon arrival in the laboratory, one of the swabs is used for culture. Which one of these selective media is an appropriate choic...
    • Case Study, continuedAfter four days of incubation at 37°C, small, shiny colonies are observed on the Regan-Lowe agar. A Gram stain of the cultur...
    • Nucleic Acid Amplification Testing (NAAT)
    • Genomic Insertion Sequences
    • Single-Copy Gene Targets
    • Positive Predictive Value
    • Addressing False-Positive NAAT Results
    • True or false: Insertion sequences can move around and insert into different locations on the genome, changing the overall genetic sequence of the bac...
    • Direct Fluorescent-Antibody Staining (DFA)
    • White Blood Cell (WBC) Count
    • Case Study, continued: IgA, IgM and IgG Antibody Testing
    • Table 2: Advantages and Disadvantages of Laboratory Tests for Identification of B. pertussis
    • Clinical Stages of Pertussis and Optimal Timing for Diagnostic Testing
    • Which of these tests may be performed late in the course of B. pertussis infection?
    • How does the prevalence of a particular pathogen in a given area correlate to positive predictive values?
• Case study conclusion
    • Case Study Conclusion
    • Treatment and Dosing for Pertussis
    • Prevention
    • Which of the following antibiotics is recommended for infants less than one month old for treatment of Bordetella pertussis infection?
• References
    • References