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[Malignant pertussis and exchange transfusion].

J Chantreuil¹, N Fakhri², F Labarthe³

¹Réanimation pédiatrique et néonatologie, hôpital Clocheville, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie

|December 4, 2014

Summary

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This summary is machine-generated.

Malignant pertussis is a severe condition with high mortality. Exchange transfusion effectively reduced extreme leukocytosis in an infant, improving outcomes before hemodynamic collapse.

Area of Science:

Pediatrics
Infectious Diseases
Critical Care Medicine

Background:

Malignant pertussis presents as a severe clinical state with high fatality rates (70%).
Key severity criteria include lung infection, pulmonary hypertension, and extreme leukocytosis (typically >50 G/L).

Observation:

A 2.5-month-old infant with malignant pertussis developed acute respiratory distress syndrome and pulmonary hypertension.
A secondary Enterobacter cloacae infection complicated the clinical course, requiring high-frequency oscillatory ventilation and pulmonary vasodilatation therapy.
Despite initial management, the infant's hyperleukocytosis reached 70 G/L.

Findings:

Exchange transfusion was performed on day 9 to address severe hyperleukocytosis.
The procedure successfully reduced leukocyte count to below 40 G/L.

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Following exchange transfusion, the infant showed steady improvement in pulmonary function, enabling weaning from mechanical ventilation and eventual discharge.

Implications:

Exchange transfusion is a viable therapeutic option for infants with malignant pertussis and extreme leukocytosis.
Considering exchange transfusion before hemodynamic failure may improve survival prognosis in these critical cases.