Objective To explore the clinical characteristics,causes of misdiagnosis and preventive measures of per-tussis in children.Methods A retrospective analysis was conducted on 272 children with pertussis treated from January 2019 to January 2022,and 191 of them were found to have been misdiagnosed.Clinical data of misdiagnosed cases were collected.Results Among 191 patients,16(8.4%)had fever,132(69.1%)had spasmodic cough,73(38.2%)had vomiting af-ter coughing,75(39.3%)had chicken-like echo,46(24.1%)had cyanosis,and 42(22.0%)had shortness of breath.There were 21(11.0%)patients with small and medium moist rales that were heard in the lungs and 57(29.8%)patients with wheezing,including3(1.6%)neonates and12(6.3%)with severe disease.There was misdiagnosis as acute bronchi-tis in 42 patients,persistent bacterial bronchitis in 21 patients,recurrent pneumonia in 17 patients,chronic pneumonia in 10 patients,bronchial asthma in 13 patients,cough variant asthma in 29 patients,and acute laryngitis in 59 patients.Misdiagno-sis lasted from 8 to 25 d.All cases were confirmed after admission by PCR or real-time fluorescent quantitative PCR for posi-tive pertussis bacilli or by the detection of pertussis specific gene sequence by gene microarray.The mixed infection rate was found to be 46.6%(54/116)in gene chip detection.All the children were cured by anti-infection,symptomatic treatment,as well as respiratory support treatment in severe cases.Conclusion The clinical characteristics of pertussis in children are obvious,which is,however,more likely to lead to misdiagnosis.Most severe cases were identified to be newborns and infants≤5 months old.Doctors should strengthen the understanding and attention of pertussis,improve the diagnostic accuracy.In the meantime,strengthening laboratory examination and timely treatment is also the key to reducing the incidence of severe diseases and mortality.
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