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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

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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.

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.

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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.