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Hyperleukocytosis with pertussis

V P McCarthy1, J R Carlile

  • 1Department of Pediatrics, University of Tennessee Medical Center at Knoxville 37920-6999, USA.

Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians
|January 1, 1997
PubMed
Summary

A rare complication of pertussis, hyperleukocytosis, occurred in an infant. This condition, marked by extremely high white blood cell counts, was successfully managed without severe respiratory issues.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Hematology

Background:

  • Pertussis (whooping cough) is a highly contagious respiratory infection caused by Bordetella pertussis.
  • While typically affecting infants and young children, pertussis can lead to severe complications.
  • Hyperleukocytosis, an abnormally high white blood cell count, is a rare but serious complication of pertussis.

Observation:

  • A 9-month-old unvaccinated infant presented with severe cough and markedly elevated white blood cell count (114,000/mm3).
  • Nasopharyngeal culture confirmed the presence of Bordetella pertussis infection.
  • The patient exhibited signs of hyperleukocytosis, a rare manifestation of pertussis.

Findings:

  • The hyperleukocytosis in this case is attributed to the lymphocytosis-promoting factor produced by Bordetella pertussis.
  • Pulmonary leukostasis, a potential consequence of hyperleukocytosis, was considered but did not lead to significant hypoxemia in this patient.
  • The infant's condition was managed, avoiding severe respiratory compromise despite the high white blood cell count.

Implications:

  • This case highlights the importance of recognizing hyperleukocytosis as a potential complication of pertussis, even in non-immunized populations.
  • Understanding the pathophysiology, including the role of lymphocytosis-promoting factor, is crucial for managing such cases.
  • Early diagnosis and monitoring can help prevent severe outcomes like hypoxemia associated with pulmonary leukostasis in pertussis-related hyperleukocytosis.

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