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Unrecognized maternal peripartum pertussis with subsequent fatal neonatal pertussis
A Beiter1, K Lewis, E F Pineda
1Department of Pediatrics, UCLA Medical Center, School of Medicine, University of California.
Insights
Adults often go undiagnosed with pertussis, posing a significant risk to infants. Early erythromycin treatment for suspected pertussis in adults and their contacts can prevent infant mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Pertussis (whooping cough) is frequently misdiagnosed in adults.
- Adults, particularly parents, are the primary source of pertussis infection in infants.
Observation:
- A pregnant woman presented with severe coughing, initially diagnosed as viral pneumonia.
- Her infant developed similar symptoms post-birth, leading to hospitalization and death.
Findings:
- Despite classic pertussis symptoms in both mother and infant, the diagnosis was missed.
- Neither patient received appropriate antimicrobial therapy due to the missed diagnosis.
Implications:
- Prompt diagnosis and treatment of pertussis in adults are crucial to prevent infant transmission.
- Erythromycin prophylaxis for suspected pertussis cases and contacts can avert severe and fatal outcomes in infants.
Background:
Pertussis is an illness that is frequently unrecognized in adults. The source of pertussis infection in young infants is usually an adult and most frequently a parent.
Case:
A woman developed severe paroxysmal coughing requiring hospitalization 6 days before delivery. She was thought to have viral pneumonia and reactive airway disease. One week after birth, her infant developed a similar illness and also required hospitalization. The infant's respiratory illness progressively worsened, resulting in death.
Conclusion:
Although the clinical findings were typical for pertussis in both the mother and infant, pertussis was not considered and therefore neither received specific antimicrobial therapy. Patients with illnesses suggestive of pertussis, and their contacts, should be treated with erythromycin before the results of laboratory studies are known, in order to prevent serious and fatal illnesses in infants.