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Neonatal malignant pertussis and exchange transfusion: A case report
Abdessamad Lalaoui1,2, Ghizlane Kassal1,2, Chaima Haidar1,2
1Neonatal Intensive Care Unit, Mother and Child Hospital, CHU Mohammed VI, Marrakech, Morocco.
Insights
Malignant whooping cough (pertussis) in neonates is severe. Exchange transfusion may improve outcomes in critical cases, but vaccination remains key for prevention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neonatology
Background:
- Whooping cough (pertussis), caused by Bordetella pertussis, is a highly contagious respiratory infection.
- Neonates are particularly vulnerable, with severe cases having a high mortality rate of approximately 70%.
Purpose of the Study:
- To report the severity of malignant whooping cough in neonates.
- To evaluate the potential benefit of exchange transfusion in improving prognosis for severe pertussis.
Main Methods:
- Case report of a 26-day-old infant with malignant whooping cough confirmed by PCR.
- Initial treatment included antibiotics (josamycin) and supportive care.
- Exchange transfusion was performed due to clinical deterioration.
Main Results:
- The infant presented with tachycardia, fever, dyspnea, and pulmonary arterial hypertension.
- Despite initial treatment, the condition worsened, necessitating exchange transfusion.
- Following exchange transfusion, the infant showed clinical improvement and was discharged after 12 days.
Conclusions:
- Exchange transfusion may be a viable option for neonates with malignant whooping cough, leukocytosis, and acute respiratory failure.
- Enhancing pertussis vaccination coverage is the most effective strategy for preventing severe cases.
Abstract:
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.
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