Hyperleukocytosis associated with pertussis: Two case reports

Area of Science:

• Pediatrics
• Infectious Diseases
• Hematology

Background:

• Pertussis, caused by *Bordetella pertussis*, remains a significant cause of severe respiratory illness and mortality in infants and children despite widespread vaccination.
• Hyperleukocytosis, characterized by extremely high white blood cell counts, is a critical factor associated with severe pertussis and increased risk of death.
• Plasma exchange is an established clinical method for reducing leukocyte counts in severe conditions.

Observation:

• The study presents two pediatric cases of pertussis initially presenting with cough, complicated by pneumonia.
• Both patients exhibited significantly elevated white blood cell counts, reaching 87.34 × 10^9/L and 55.46 × 10^9/L, respectively.
• These children received a combination of anti-infective therapy, plasma exchange, and ventilatory support.

Findings:

• Plasma exchange was employed as a therapeutic intervention to reduce the markedly elevated leukocyte counts.
• Both children demonstrated a positive clinical response and recovered following the implemented treatment regimen.
• The findings suggest a direct correlation between hyperleukocytosis and disease severity in pediatric pertussis.

Implications:

• Early diagnosis of pertussis complicated by hyperleukocytosis is crucial for timely intervention.
• Prompt initiation of plasma exchange in pediatric pertussis cases with hyperleukocytosis can significantly improve patient prognosis.
• This therapeutic approach holds the potential to reduce mortality rates associated with severe pertussis in vulnerable pediatric populations.