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Fatal Bordetella pertussis infection: report of two cases with novel pathologic findings
R Hackman1, D G Perrin, M Karmali
1Department of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada.
Abstract:
We report two infants less than 2 months of age who died of Bordetella pertussis infection: one of primary B. pertussis infection and the other of secondary bronchopneumonia. We describe histopathologic findings in the lung, including transmission and immunoelectron microscopy, studies showing close association between B. pertussis organisms and ciliated cells. A novel finding in both cases was striking dilatation and inspissation of proteinaceous material in pancreatic ducts, reminiscent of changes described in cystic fibrosis. The possible mechanism for these changes may be related to cellular and molecular actions of pertussis toxin-a powerful inhibitor of G proteins and adenyl cyclase important in cellular signal transduction.
Insights
Two infants died from Bordetella pertussis infection, with one case showing secondary bronchopneumonia. Researchers observed pancreatic duct changes similar to cystic fibrosis, possibly linked to pertussis toxin's cellular effects.
Area of Science:
- Pediatric Infectious Diseases
- Cellular Pathology
- Microbiology
Background:
- Pertussis, caused by Bordetella pertussis, is a significant threat to infants.
- Understanding the severe pathology of pertussis in neonates is crucial for public health.
- Histopathological analysis aids in elucidating disease mechanisms.
Observation:
- Two infants under two months old succumbed to Bordetella pertussis infection.
- Histopathological examination revealed B. pertussis associated with ciliated lung cells.
- A novel observation was significant dilation and proteinaceous material in pancreatic ducts.
Findings:
- The study identified primary B. pertussis infection and secondary bronchopneumonia as causes of infant mortality.
- Microscopic analysis demonstrated a close association between B. pertussis and respiratory ciliated cells.
- Pancreatic duct changes, resembling cystic fibrosis, were noted in both cases.
Implications:
- These findings suggest a potential link between pertussis toxin and pancreatic duct pathology.
- Pertussis toxin's role as a G protein inhibitor may explain observed cellular signal transduction disruptions.
- This research highlights a previously unrecognized potential complication of severe pertussis in infants.