Confusable diagnoses · PANCE / PANRE

Bronchiolitis vs Pertussis

Bronchiolitis and Pertussis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Bronchiolitis vs Pertussis at a glance

  • Bronchiolitis: Viral lower respiratory tract infection of infants causing wheeze, hypoxia, and dehydration.
  • Pertussis: Bordetella pertussis respiratory infection with paroxysmal cough and inspiratory whoop.
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Side-by-side comparison

FeatureBronchiolitisPertussis
At a glanceViral lower respiratory tract infection of infants causing wheeze, hypoxia, and dehydration.Bordetella pertussis respiratory infection with paroxysmal cough and inspiratory whoop.
Classic presentation1-3 days of URI symptoms (rhinorrhea, cough, low-grade fever); Progression to lower respiratory tract: tachypnea, wheeze, cough, increased work of breathing;…Paroxysmal coughing fits with inspiratory whoop and post-tussive emesis lasting >2 weeks in a child or adolescent. Apnea (not cough) in young infant.;…
Workup / key labsClinical diagnosis — routine viral testing NOT recommended in typical cases (does not change management); RSV testing may help with cohorting, public health…CDC clinical case definition: cough ≥2 weeks with paroxysms, inspiratory whoop, OR post-tussive emesis without other apparent cause. Laboratory confirmation:…
ImagingChest radiograph NOT routinely recommended (AAP 2014) — risk of overdiagnosis of pneumonia and unnecessary antibiotics; Obtain CXR if focal exam findings,…Chest radiograph: often normal or shows perihilar infiltrate ('shaggy heart border'); rules out pneumonia and other complications
First-line treatmentSupportive care — cornerstone:; Suction nasal secretions (gentle bulb suction before feeds; deep suction NOT recommended); Hydration: oral/NG feeds if…Antibiotic treatment primarily REDUCES TRANSMISSION; clinical benefit greatest if started in catarrhal or early paroxysmal phase; Macrolide first-line:;…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.