Objective: To analyze the clinical data of children with
pertussis and explore the necessity of respiratory virus detection in the combined diagnosis so as to improve the clinician's understanding and standardize the diagnosis and treatment of
pertussis in children. Method: Clinical data and laboratory examination of 195 suspected
pertussis children between Jan. 2015 and Dec. 2016 in Children's Hospital Affiliated to Capital Institute of Pediatric were analyzed retrospectively. Result: The nasopharyngeal secretions were collected from 195 suspected
pertussis children, PCR was employed to detect the
nucleic acid of Bordetella pertussis. Meanwhile, 172 of 195 cases were screened for
antigens of 7 common respiratory viruses by direct immunofluorescence (DIF) (respiratory syncytial virus(RSV), adenovirus(ADV), influenza virus A and B,
parainfluenza viruses type Ⅰ-Ⅲ). (1) Eighty cases were positive in
pertussis nucleic acid detection (positive rate was 41.0%), 47 males and 33 females, age ranged from one month to ten years, all of them had paroxysmal
cough (100.0%), 50 cases with spasmodic
cough (62.5%), 9 cases with
vomiting after
cough(11.2%), 22 cases with
cyanosis after
cough(27.5%), 13 cases with roaring after
cough(16.2%), 4 cases with
dyspnea(5.0%), 18 cases were diagnosed as
pneumonia by chest radiography(22.5%) and 1 case was diagnosed as
pertussis encephalopathy(1.2%); (2) 172 cases of respiratory virus DIF detection were completed and 69 of them were positive(positive rate was 40.1%), including 32 cases positive for RSV(18.6%), 29 cases for PIVⅢ(16.8%); (3) In 80 confirmed
pertussis children, 66 cases of respiratory virus DIF detection were completed and 9 were positive(9/66, 13.6%), including 7 cases positive for PIVⅢ. The clinical manifestations were
cyanosis after
cough(6 cases),
dyspnea(2 cases) and
pneumonia were diagnosed by chest radiography in 3 cases, the clinical symptoms of these children were more prominent than children with general
pertussis; (4) Patients were divided into three groups according to the pathogens: 57 cases in single
pertussis group, 32 cases in
RSV infection group, 22 cases in single PIVⅢ
infection group.The cases of spasmodic
cough in
Pertussis group was 35 (61.4%),
RSV infection group was 7(21.9%), single PIVⅢ
infection group was 8(36.4%), compared with the other two groups, the incidence of spasmodic
cough were higher in
Pertussis group (χ(2) =12.850, 4.013, P<0.05). The cases of roaring in
Pertussis group was 11 (19.3%),
RSV infection group was 1(3.1%), single PIVⅢ
infection group was 0, and the incidence were higher in
Pertussis group (χ(2)=4.596, 4.932, P<0.05). The cases of
dyspnea in
Pertussis group was 2 (3.5%),
RSV infection group was 11(34.4%), single PIVⅢ
infection group was 0, and the incidence was higher in
RSV infection group (χ(2)=15.654, 9.487, P<0.01). Conclusion:
Pertussis is common in children, especially in unvaccinated or incompletely vaccinated infants. The typical clinical manifestation is paroxysmal spasmodic
cough; complicated with PIVⅢ
infection is a risk factor for sever
pertussis. Early detecting of Bordetella by PCR is helpful for the diagnosis of
pertussis, RSV and PIVⅢ are the main pathogen for
Pertussis-like syndrome. The detection of respiratory virus is helpful for differential diagnosis and medication guidance.