PREDNOSTI I NEDOSTACI RENDGENSKE DIJAGNOSTIKE ZA OBOLELE OD VELIKOG KAŠLJA
Sažetak
Svetska zdravstvena organizacija opisuje veliki kašalj kao „izuzetno zaraznu bolest respiratornog trakta koju uzrokuje Bordetella pertussis", mikroorganizam specifično patogen za ljude. Veliki kašalj pogađa sve uzraste, posebno decu i jedan je od vodećih uzroka smrti kod dece mlađe od jedne godine. Inkubacija obično traje 7 do 10 dana, a klinička slika zavisi od uzrasta i vakcinalnog statusa. Dijagnoza velikog kašlja često predstavlja izazov zbog simptoma koji su slični onima kod drugih respiratornih infekcija. Kod odraslih obično bolest prolazi asimptomatski ili se javlja blaga simptomatska infekcija, posebno kod starijih koji su prethodno vakcinisani. Međutim, kod dece mlađe od 5 godina, posebno odojčadi, je teža klinička slika u vidu paroksizmalnog kašlja, koji može biti praćen karakterističnim vizingom ili inspiratornim hukom i izbacivanjem male količine lepljive sluzi, a može da dođe i do pojave dispneje, cijanoze i apneje. Komplikacija koja se najčešće javlja kod nevakcinisane dece je bronhopneumonija. U cilju dijagnostikovanja bolesti, pored specifične kliničke slike, najčešće se koristi bris ili aspirat nazofaringsa za PCR testiranje ili kultivaciju bakterije i krv za serološke analize. Rendgenski snimak pluća kod lica sa sumnjom na veliki kašalj može imati značajnu ulogu u proceni komplikacija i diferencijalnoj dijagnozi, a kod mlađih od četiri godine i za olakšavanje postavljanja dijagnoze. Međutim, nedostaci rendgenskog snimanja pluća su napadi kašlja prilikom snimanja, nemogućnost otkrivanja bolesti u ranom stadijumu, izlaganja pacijenta jonizujućem zračenju i grešake u interpretaciji snimaka.
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