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Re: Central apnoea and bradycardia documented on polysomnography in an infant infected with pertussis

Dear Editor

Pertussis is generally not suspected and under diagnosed in the early infancy nowadays.[1]

The presentation is often atypical. Sixty percent (20/33) of the infants observed in this study presented with apnoea. Pertussis related apnoeas have not been described in detail in literature. We recently reported polysomnographic studies of 3 infants with unexpected, prolonged central apnoeas infected with respiratory syncytial virus (RSV).[2] In accordance to this observation we report an infant infected with pertussis presenting with a central apnoea on polysomnography. A male infant was born prematurely at the postconceptional age of 32 weeks with a birth weight of 1790 grams. He had an uncomplicated neonatal period. He was discharged with a home cardiorespiratory monitor because of immature cardiorespiratory control. At the age of 3 months he presented with severe bradycardia revealed by the home monitor. Later, he developed typical whooping cough occasionally followed by vomiting. Treatment with macrolide antibiotic was started. He was transferred to the neonatal intensive care unit because of severe desaturation and bradycardia. He improved progressively the following days and respiratory support could be avoided. Polymerase chain reaction was positive for Bordetella pertussis confirming the diagnosis. Infection with RSV was excluded. Conclusion: In the young infant pertussis should be included in the differential diagnosis of central apnoea.

References

1 Crowcroft NS, Booy R, Harrison T, Spicer L, Britto J, Mok Q, et al. Severe and unrecognised: pertussis in UK infants. Arch Dis Child 2003;88:802-6.