In adults, especially those vaccinated, this finding is rare. Definitive culture diagnosis is not always possible. Blood cultures uniformly are negative. An immediately plated, deep, nasopharyngeal swabbing grown for 1 week in Bordet-Gengou agar classically is considered to be the gold standard of diagnosis. Currently, the DFA studies provide the majority of case confirmations along with a consistent history.
Results can be available within minutes.
Careful observation for apnea, cyanosis, or hypoxia in infants. Under 1 year of age. Apneic or cyanotic spells. Moderate to severe dehydration. Antibiotics - Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.