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Clinically, significantly fewer infants with pertussis than controls had more episodes of whooping cough (63.2% vs 0.0%; p\u2009&lt;\u20090.001) and also less frequently fever at admission (15.8% vs 68.4%; p &lt;0.01), apnea (52.6% vs 10.5%; p &lt;0.006), and cyanosis (52.6% vs 10.5%; p\u2009&lt;\u20090.006). Infants with pertussis had more often no abnormal chest sounds on auscultation than infants with RSV bronchiolitis (0% vs 42,1%; p\u2009&lt;\u20090.005). The absolute blood lymphocyte and eosinophil counts were higher in infants with<jats:italic>B. pertussis<\/jats:italic>than in controls with bronchiolitis (23886\u2009\u00b1\u200916945 vs 10725\u2009\u00b1\u20094126 cells\/mm<jats:sup>3<\/jats:sup>, p\u2009&lt;\u20090.0001 and 13.653\u2009\u00b1\u200910.430 vs 4.730\u2009\u00b1\u20092.400 cells\/mm<jats:sup>3<\/jats:sup>, p\u2009&lt;\u20090.001). The molecular analysis of 2<jats:italic>B. pertussis<\/jats:italic>isolates for<jats:italic>ptxA1<\/jats:italic>,<jats:italic>ptxP3<\/jats:italic>, and<jats:italic>prn2<\/jats:italic>genes showed the presence of gene variants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When infants are hospitalized for acute respiratory symptoms, physicians should suspect a pertussis infection, seek for specific clinical symptoms, investigate lymphocyte and eosinophil counts and thus diagnose infection early enough to allow treatment.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-13-526","type":"journal-article","created":{"date-parts":[[2013,11,8]],"date-time":"2013-11-08T16:01:32Z","timestamp":1383926492000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Bordetella pertussis in infants hospitalized for acute respiratory symptoms remains a concern"],"prefix":"10.1186","volume":"13","author":[{"given":"Ambra","family":"Nicolai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella","family":"Nenna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Stefanelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Carannante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Concetta","family":"Schiavariello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Pierangeli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Scagnolari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Moretti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Papoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enea","family":"Bonci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Ferrara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Papasso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Midulla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,11,8]]},"reference":[{"key":"2715_CR1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s00431-007-0548-2","volume":"167","author":"ES Bamberger","year":"2008","unstructured":"Bamberger ES, Srugo I: What\u2019s new in pertussis?. 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