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Asthma and pertussis
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Asthma and pertussis

I am 42 yrs old, and have been asthmatic most of my life. I have always been a non-smoker.
I was exposed to an infant that had pertussis (Swab positive). Of course, I didn't know he had pertussis yet, so didn't have a mask on. Sure enough, about 10 days later, I developed what I thought was a really bad cold, with a lot of nasal and sinus congestion, and feeling rotten.
My asthma is generally really well controlled on Singulair, and I add Advair when I am getting a cold. I started my Advair with this cold, but my asthma very quickly got out of control. I ended up spending and evening in the emergency dep't 4 days into my cold, as my chest was very very tight, and a lot of ventolin was not helping much or for very long. After quite a few Ventolin treatments, a chest x-ray, and some prednisone, I was able to be discharged. I had already started some Biaxin earlier in the day, as I had been informed that my patient's pertussis test had come back positive.
My question is whether or not pertussis would really aggravate my asthma. Regular colds usually do aggravate it somewhat, but this time is really bad. My chest x-ray was clear, with no pnuemonia (pneumonia).My URTI symptoms are subsiding, but I am coughing and my chest is really tight. I am needing Ventolin probably every 2 to 3 hours, which is an improvement on the day I ended up in ER. I didn't get an actual pertussis swab done, just was treating on spec, so I won't infect anyone else. Oh, and I had an adacell in 2008.
Since pertussis causes inflammation of the lining of the airways, it would make sense that it could really aggravate my asthma. Will it just cause a flare up like a regular cold, or will it continue to flare badly for the whole coughing and recovery stage? Is there anything else to do to calm it if it will flare this badly for that long? I know pertussis is the "100 day cough" - I am just not sure if it wll also be the 100 day asthma attack as well!!
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You have provided a nicely detailed description of what has transpired, especially with your asthma, since your exposure to an active case of pertussis.  Pertussis is primarily a disease of the respiratory tract that typically has an acute, sub-acute and, in many instances chronic, this latter not uncommonly lasting 3-6 months.  The infection with pertussis  can initiate and/or worsen the bronchial hyper-reactivity, characteristic of asthma, without your developing pneumonia and the timing of your infection and the subsequent dramatic worsening of your asthma strongly suggest a cause and effect.  So, to answer your question, it is highly likely that pertussis not only can, but did aggravate your asthma.

There is no way to predict the subsequent course of your worsened asthma but the historically well-documented (by many studies) persistence of the infectious organism in the airways for months makes it highly likely, in my opinion, that your asthma may be clinically worse and more difficult to control for as long as the pertussis bacteria remain in your airways or the increased inflammation and bronchial hyper-reactivity even persist for some time after your immune system has completely eradicated the pertussis infection.

You ask, “Is there anything else to do to calm it if it will flare this badly for that long?    Nothing specific.  It is too late for antibiotics.  Attempting to suppress inflammation with higher than usual doses of inhaled corticosteroids is worthy of consideration and the continuance of Singulair, for the benefit of its anti-inflammatory effect.  

I conducted a literature search, but could not find any other therapy, recommended for this circumstance.

The return of your asthma to baseline may take a long time and much patience on your part.

Good luck
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