Hemolytic uremic syndrome caused by Bordetella pertussis infection

We report the case of a 4-week-old infant with severe Bordetella pertussis infection resulting in hemolytic anemia, thrombocytopenia, and acute renal failure leading to a diagnosis of hemolytic uremic syndrome (HUS) associated with pertussis. In addition to antibiotic and supportive therapy, he was treated with plasma transfusions based on the possibility of underlying complement defect, and he improved. The association of B. pertussis infection and HUS has previously been described in a patient with a mutation in the gene encoding complement factor H (CFH). However, whereas a genetic workup for complement regulator mutations was performed, no mutation was found in our patient. This case demonstrates the possible association between pertussis infection and HUS and highlights the need for increased vigilance for renal complications in this diagnosis. Despite negative results in this case, in-depth workup of the complement system may be important to guide treatment efforts and strategies.