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Clinical Profile, Outcome and Risk Factors for Mortality Among Children Admitted with Critical Pertussis: An
Asruti Kacha1, Pareshkumar Amrutlal Thakkar2, Dhairya Gandhi1
1Department of Pediatrics, Government Medical College Baroda and SSG Hospital, Vadodara, Gujarat, 390001, India.
Indian Pediatrics
|April 1, 2026
Summary
Critical pertussis in children often presents as severe pneumonia, caused by Bordetella species. Shock is a significant predictor of mortality in these severe cases.
Area of Science:
- Pediatric Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Pertussis, also known as whooping cough, remains a significant public health concern globally.
- Critical pertussis in infants and young children can lead to severe respiratory distress and high mortality rates.
- Understanding the clinical spectrum and risk factors is crucial for timely intervention.
Purpose of the Study:
- To investigate the clinical and microbiological characteristics of critical pertussis in children.
- To identify outcomes and risk factors associated with mortality in pediatric intensive care unit (PICU) patients with critical pertussis.
- To determine the etiological agents responsible for severe pertussis cases.
Main Methods:
- An ambispective study was conducted on 75 children diagnosed with critical pertussis and admitted to the PICU.
- Diagnosis was confirmed using real-time polymerase chain reaction (PCR).
- Clinical data, complications, and patient outcomes, including mortality, were systematically recorded.
Main Results:
- Bordetella infection was confirmed in 76% of cases (34 B. pertussis, 23 other Bordetella species).
- Common symptoms included fever, paroxysmal cough, and tachypnea, with all patients showing diffuse infiltrates on chest X-ray.
- High rates of complications were observed: hypoxemia (92%), shock (54.7%), encephalopathy (50.7%), and seizures (38.7%).
- Mechanical ventilation was required for 84% of patients, and 50.7% expired.
- Shock emerged as an independent risk factor for mortality (aOR 7.63, P=0.002).
Conclusions:
- Critical pertussis frequently manifests as severe pneumonia and can be attributed to both B. pertussis and other Bordetella species.
- The presence of shock significantly increases the risk of mortality in children suffering from critical pertussis.
- Early recognition of shock is vital for improving outcomes in severe pertussis cases.
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