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Missed Pertussis—Still With Us

VINCENT A. FULGINITI, MD; C. GEORGE RAY, MD
Am J Dis Child. 1985;139(7):656. doi:10.1001/archpedi.1985.02140090018015.
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In this issue of AJDC, Sotomayor and colleagues present their experience during an eight-year period with the missed or delayed diagnosis of pertussis in young infants.1 One might ask, "So what's new? Why accept and publish the obvious? Doesn't everyone know that some people miss this diagnosis?" We elected to publish this report for the very reason that inspires such questions. Pertussis in young infants continues to be missed, and we should not become complacent about it.

Classic pertussis, once seen, is unlikely to be mistaken for any other respiratory infection in infancy. The severely ill infant with paroxysmal cough, struggling to breathe against the thick, abundant mucoid discharge that fills the airway, creates an image in one's mind that resists forgetting. The characteristic whoop, often with vomiting and the suffused, cyanotic facies that accompany it, likewise leave an indelible impression. However, this typical picture

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