Severe pertussis infection: A clinicopathological study.

Area of Science:

• Pediatrics
• Infectious Diseases
• Pathology

Background:

• Pertussis (whooping cough) remains a significant public health concern, particularly for infants.
• Understanding the clinical and pathological features of severe pertussis is essential for improving patient outcomes.

Purpose of the Study:

• To investigate the clinicopathological characteristics of pertussis in hospitalized children.
• To identify risk factors for pediatric intensive care unit (PICU) admission and mortality.

Main Methods:

• Retrospective cohort study of pediatric pertussis admissions from 2008-2014.
• Analysis of clinical data, laboratory results, and autopsy findings.
• Statistical analysis to determine risk factors and predictive values of leukocyte count.

Main Results:

• Of 55 confirmed cases, 30.9% required PICU admission and 10.9% died.
• All deaths occurred in infants under 60 days old, who were unvaccinated.
• Leukocyte count ≥40,000/mm³ predicted PICU admission; a count of 41,200/mm³ showed high sensitivity and specificity for predicting death (AUC 0.93).
• Autopsies revealed pulmonary hypertension in 80% of cases, with medial thickening of pulmonary arteries but no leukocyte aggregates or thrombosis.

Conclusions:

• Marked leukocytosis at presentation is associated with increased morbidity and mortality in pediatric pertussis.
• Preventive strategies, especially vaccination for infants, are critical to reduce severe pertussis incidence and outcomes.