{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:11:51Z","timestamp":1780499511638,"version":"3.54.1"},"reference-count":26,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Wheezing in children is most often attributed to asthma; however, infectious etiologies, such as\n                    <jats:italic>Bordetella pertussis<\/jats:italic>\n                    , may present with atypical manifestations, including wheezing, particularly in older children. Such presentations pose a diagnostic challenge and frequently result in misdiagnosis and delayed treatment. We describe three nonatopic school-aged children who presented with prolonged, predominantly nocturnal cough and wheezing and were initially managed as cases of new-onset uncontrolled asthma without clinical improvement. All were subsequently diagnosed with pertussis using multiplex polymerase chain reaction testing of throat swabs and demonstrated prompt clinical response to azithromycin therapy. These cases highlight pertussis as an important asthma mimic in older children and underscore the need for heightened clinical suspicion in patients with persistent cough, poor response to bronchodilators and inhaled corticosteroids, normal inflammatory markers, and relative lymphocytosis. Early recognition is critical to reduce morbidity and limit ongoing transmission, particularly in tropical and resource-limited settings where pertussis may be underdiagnosed.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0565","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T17:35:29Z","timestamp":1775669729000},"page":"1066-1068","source":"Crossref","is-referenced-by-count":0,"title":["Pertussis Presenting as New-Onset Uncontrolled Asthma in Children: A Series of Three Cases"],"prefix":"10.4269","volume":"114","author":[{"given":"Manish","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Command Hospital (Northern Command), Udhampur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simple","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Command Hospital (Northern Command), Udhampur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepu K.","family":"Peter","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Command Hospital (Northern Command), Udhampur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Rani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Command Hospital (Northern Command), Udhampur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Utkarsh","family":"Suyal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Command Hospital (Northern Command), Udhampur, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Eur J Epidemiol","first-page":"1013","article-title":"Is pertussis being considered as a cause of persistent cough among adults?","author":"Couzigou","year":"2003"},{"key":"b2","series-title":"Pediatr Infect Dis J","first-page":"351","article-title":"Wheezing in children with pertussis associated with delayed pertussis diagnosis","author":"Taylor","year":"2014"},{"key":"b3","series-title":"Clin Microbiol Rev","first-page":"326","article-title":"Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies","author":"Mattoo","year":"2005"},{"key":"b4","series-title":"Med Hypotheses","first-page":"101","article-title":"The pertussis hypothesis: Bordetella pertussis colonization in the etiology of asthma and diseases of allergic sensitization","author":"Rubin","year":"2018"},{"key":"b5","series-title":"Clin Exp Allergy","first-page":"176","article-title":"Familial and environmental determinants for wheezing and asthma in a case-control study of school children in Palestine","author":"El-Sharif","year":"2003"},{"key":"b6","series-title":"J Asthma Allergy","first-page":"1","article-title":"Risk factors for asthma and allergic diseases in school children across Lebanon","author":"Waked","year":"2008"},{"key":"b7","series-title":"Allergy","first-page":"314","article-title":"Risk factors for childhood asthma in Croatia","author":"Aberle","year":"2010"},{"key":"b8","series-title":"Vaccine","first-page":"8275","article-title":"Pertussis in infancy and the association with respiratory and cognitive disorders at toddler age","author":"de Greeff","year":"2011"},{"key":"b9","series-title":"Epidemiology","first-page":"699","article-title":"Family size, infections, and asthma prevalence in New Zealand children","author":"Wickens","year":"1999"},{"key":"b10","series-title":"Thorax","first-page":"927","article-title":"Early childhood infection and atopic disorder","author":"Farooqi","year":"1998"},{"key":"b11","series-title":"BMJ","first-page":"1173","article-title":"Pertussis vaccination and wheezing illnesses in young children: Prospective cohort study. The Longitudinal Study of Pregnancy and Childhood Team","author":"Henderson","year":"1999"},{"key":"b12","series-title":"J Allergy Clin Immunol","first-page":"957","article-title":"Increased risk of pertussis in patients with asthma","author":"Capili","year":"2012"},{"key":"b13","series-title":"BMJ","first-page":"299","article-title":"Natural course of 500 consecutive cases of whooping cough: A general practice population study","author":"Jenkinson","year":"1995"},{"key":"b1","series-title":"Eur J Epidemiol","first-page":"1013","article-title":"Is pertussis being considered as a cause of persistent cough among adults?","author":"Couzigou","year":"2003"},{"key":"b2","series-title":"Pediatr Infect Dis J","first-page":"351","article-title":"Wheezing in children with pertussis associated with delayed pertussis diagnosis","author":"Taylor","year":"2014"},{"key":"b3","series-title":"Clin Microbiol Rev","first-page":"326","article-title":"Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies","author":"Mattoo","year":"2005"},{"key":"b4","series-title":"Med Hypotheses","first-page":"101","article-title":"The pertussis hypothesis: Bordetella pertussis colonization in the etiology of asthma and diseases of allergic sensitization","author":"Rubin","year":"2018"},{"key":"b5","series-title":"Clin Exp Allergy","first-page":"176","article-title":"Familial and environmental determinants for wheezing and asthma in a case-control study of school children in Palestine","author":"El-Sharif","year":"2003"},{"key":"b6","series-title":"J Asthma Allergy","first-page":"1","article-title":"Risk factors for asthma and allergic diseases in school children across Lebanon","author":"Waked","year":"2008"},{"key":"b7","series-title":"Allergy","first-page":"314","article-title":"Risk factors for childhood asthma in Croatia","author":"Aberle","year":"2010"},{"key":"b8","series-title":"Vaccine","first-page":"8275","article-title":"Pertussis in infancy and the association with respiratory and cognitive disorders at toddler age","author":"de Greeff","year":"2011"},{"key":"b9","series-title":"Epidemiology","first-page":"699","article-title":"Family size, infections, and asthma prevalence in New Zealand children","author":"Wickens","year":"1999"},{"key":"b10","series-title":"Thorax","first-page":"927","article-title":"Early childhood infection and atopic disorder","author":"Farooqi","year":"1998"},{"key":"b11","series-title":"BMJ","first-page":"1173","article-title":"Pertussis vaccination and wheezing illnesses in young children: Prospective cohort study. The Longitudinal Study of Pregnancy and Childhood Team","author":"Henderson","year":"1999"},{"key":"b12","series-title":"J Allergy Clin Immunol","first-page":"957","article-title":"Increased risk of pertussis in patients with asthma","author":"Capili","year":"2012"},{"key":"b13","series-title":"BMJ","first-page":"299","article-title":"Natural course of 500 consecutive cases of whooping cough: A general practice population study","author":"Jenkinson","year":"1995"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/6\/article-p1066.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/6\/article-p1066.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/114\/6\/article-p1066.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:16:06Z","timestamp":1780496166000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/114\/6\/article-p1066.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":26,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0565","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]}}}