A 38-year-old woman presents to the emergency room with a dry hacking cough. She indicates that she has had the cough for approximately four weeks and a low-grade fever at times, but never higher than 100°F. She states that she has terrible coughing spells where it is difficult to stop, and her sleep is often interrupted by coughing. Also, she has shortness of breath when she lies down.
During the physical examination, the patient has several episodes of numerous rapid coughs, each followed by an inspiratory effort that includes a high-pitched whoop. Her temperature is 99.0°F. She confirms that she has never received a pertussis booster vaccine and is currently not on antimicrobial therapy.
Based on the patient's symptoms and the nature and history of the cough, the physician suspects whooping cough and orders a Bordetella pertussis culture, among other tests.
