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Severe pertussis and hyperleukocytosis: is it time to change for exchange?

Amir Kuperman1, Yoav Hoffmann, Danny Glikman

  • 1Pediatric Hematology Clinic and Coagulation Service, Western Galilee Hospital, Naharia, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.

Transfusion
|December 17, 2013
PubMed

Insights

Exchange transfusion (ET) is a critical treatment for severe pertussis (whooping cough) with hyperleukocytosis in infants. This case report suggests ET can lead to recovery without lasting effects, highlighting its importance in managing this severe condition.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Pertussis remains a significant global cause of infant mortality, posing a public health challenge.
  • Severe pertussis, characterized by hyperleukocytosis, carries an extremely high mortality rate (up to 80%).
  • Previous studies on exchange transfusion (ET) for reducing white blood cell burden in critical pertussis have yielded conflicting results.

Observation:

  • This report details a case of critical pertussis with hyperleukocytosis in a neonate.
  • The neonate underwent exchange transfusion (ET) as a therapeutic intervention.
  • A comprehensive literature review was conducted in conjunction with the case management.

Findings:

  • The neonate treated with ET experienced a full recovery.
  • The patient was discharged from the hospital without any long-term sequelae.
  • This outcome suggests the efficacy of ET in managing severe pertussis.

Implications:

  • Exchange transfusion (ET) should be strongly considered for all infants diagnosed with critical pertussis and hyperleukocytosis.
  • The consideration of ET is warranted even in secondary care community hospital settings.
  • This approach may improve outcomes for infants with this life-threatening condition.
Abstract

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