Neonatal malignant pertussis and exchange transfusion: A case report

Whooping cough (pertussis) is a bacterial infection caused by Bordetella pertussis. It poses a significant risk, especially in neonates. This contagious respiratory infection is transmitted via the aerosol route from human reservoirs. The severe form can lead to mortality in approximately 70% of cases. The aim of our study is to report the severity of malignant whooping cough in neonates and the potential contribution of exchange transfusion to improving prognosis. In this case, a 26-day-old infant presented with malignant whooping cough, confirmed by PCR testing. Initial clinical findings included tachycardia, fever, dyspnea, and right apical lesion with pulmonary arterial hypertension. Despite initial treatment with josamycin and supportive measures, the patient's condition deteriorated, requiring an exchange transfusion, which led to clinical improvement. The patient was successfully discharged after a 12-day hospitalization. Exchange transfusion should be considered for malignant whooping cough with leukocytosis and acute respiratory failure, but enhancing vaccination coverage remains the most effective prevention strategy.