What symptoms rule out whooping cough in adults?

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Takeaway

  • In adult patients the presence of whooping or post-tussive vomiting should rule in a possible diagnosis of pertussis, whereas the lack of a paroxysmal cough or the presence of fever should rule it out.

Why this matters

  • Pertussis (whooping cough) is a highly infective cause of cough that causes significant morbidity and mortality.

Study design

  • 53 studies involving 23796 participants (4149 had a diagnosis of pertussis) met eligibility criteria after a search on CINAHL, EMBASE, Medline and SCI-EXPANDED/CPCI-S up to June 2016.
  • Funding: None disclosed.

Key results

  • Of 53 included studies, 37 had a prospective design, 12 were retrospective and 4 were case-control studies.
  • Paroxysmal cough and absence of fever had a high sensitivity (93.2%; 95% CI 83.2-97.4 and 81.8%...