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Hyperleukocytosis associated with pertussis: Two case reports.

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Severe pertussis in children can lead to death, especially with hyperleukocytosis. Early identification and plasma exchange treatment can improve outcomes and reduce mortality in these critical cases.

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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.