| Popis: |
Components of Bordetella pertussis cause impairment of cell-mediated immunity in experimental animals and children with acute pertussis have been shown to have a reduced prevalence of positive tuberculin skin tests (13). Furthermore, secondary infection is one of the major causes of morbidity and mortality in this disease. On the basis of these observations, we have studied delayed hypersensitivity responses in children with B. pertussis infection and compared the results with responses elicited in the same patients one to three months later, as well as with responses in control children. During acute illness, each patient was tested for 48 hour delayed hypersensitivity response to seven antigens (tetanus and diphtheria toxoids and tuberculin, candida, streptococcus, trichophyton and proteus antigens) and glycerol control. Responses were quantitated by total number of antigens positive (greater than or equal to 2 mm) and total millimeters of response. The control group (N = 11) had 4.2 +/- 1.0 positive antigens and 13.3 +/- 2.7 total mm of response. In contrast, the patients with acute pertussis, (N = 6) had significantly reduced responses, with only 1.5 +/- 1.0 positive antigens and 5.4 +/- 3.2 total mm of response (each different from control, p less than 0.001). That this difference was due to the acute infection with B. pertussis is supported by the responses demonstrated on retest 1-3 months later. At that time, the convalescent patients had 3.3 +/- 1.0 antigens positive and 11.0 +/- 1.7 mm of induration, not significantly different from the control group. Four of the six pertussis patients were outpatients throughout their course and all recovered uneventfully.(ABSTRACT TRUNCATED AT 250 WORDS) |
