RT Journal Article SR Electronic T1 Angioedema as a predominant symptom of Bordetella pertussis infection JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e239243 DO 10.1136/bcr-2020-239243 VO 14 IS 3 A1 Christina Bal A1 Ruth Baumgartner A1 Daniela Gompelmann A1 Marco Idzko YR 2021 UL http://casereports.bmj.com/content/14/3/e239243.abstract AB A 41-year-old woman was referred to our hospital with a 6-week history of severe angioedema, dyspnoea and coughing. Initial investigations focused on common causes of angioedema. Clinical presentation and resistance to treatment with antihistamines and steroids made histamine-mediated angioedema unlikely. Bradykinin-mediated angioedema, such as hereditary or drug-induced angioedema, was excluded by a thorough history investigation and laboratory testing for C1-esterase and C4.In rare cases, exogen pathogens cause angioedema. After profound testing for respiratory pathogens, Bordetella pertussis toxins IgA and IgG were found to be positive, indicating recent B. pertussis infection. Pertussis toxin may be responsible for increased vascular permeability causing angioedema. With adequate antibiotic treatment, the symptoms resolved quickly.This case is an example of an atypical presentation of B. pertussis infection in an unvaccinated adult. The recent resurgence of pertussis makes early diagnosis and disease prevention by vaccination crucial.