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571 Malignant Pertussis in the Young Infant: a Case Report
  1. M Benedit,
  2. I Llana,
  3. MT Garcia de Alvaro,
  4. M Fernandez,
  5. S Jimeno
  1. Hospital HM Torrelodones, Madrid, Spain

Abstract

Infections by bordetella pertussis, has resurged in many countries around the world including developed regions. Where as new vaccination strategies for adolescents, pregnant women and adults have been recommended, mortality afecting young infants is still significant. Patients with severe cases present with extreme leukocytosis and develop refractory hypoxemia and pulmonary hypertension that is unresponsive to maximal intensive care.

Objective To report a case of malignant pertussis in a 4 weeks old infant.

Design a descriptive case report.

Patient a 4 weeks old boy was admitted to the intensive Care Unit with respiratory distress and a diagnosis of bronchiolitis. Both parents and a 19 months old sibbling had upper respiratory infection symptoms. Four days before admission he started with coryza and cough. The cough was not paroxismal and cianosis and whooping were never present. He presented a marked leucocytosis wih lymphocytosis. Respiratory failure occurred rapidly from the fourth day with subsequent deterioration due to the development of severe pulmonary hypertension and multiorganic failure which caused the infant’s death after 4 days of intensive care therapy.

Although Bordetella Pertussis was not confirmed by PCR, culture o serology the findings on the autopsy were suggestive of malignant pertussis.

Comments mortality due to malignant pertussis remains superior to 75% regardless life suport measures. Adults are the main source of contamination of non-immunized infants, thus immunization of older adolescents and adults who will have close contact with infants aged < 12 months is the most effective preventive measure.

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