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Coqueluche en niños menores de seis meses de vida

2001; Elsevier BV; Volume: 72; Issue: 4 Linguagem: Inglês

10.4067/s0370-41062001000400008

0717-6228

Alejandro Donoso F, Adriana Wegner A., José León B, Milena Ramírez A., Juan A. Carrasco O.,

Infective Endocarditis Diagnosis and Management

Objective: to analyze our experience in non-immunized or partially immunized children with Bordetella pertussis infection. To describe the importance of secondary pulmonary hypertension as a cause of death in this group of children. Method: analyze of all patients with Bordetella pertussis infection hospitalized in the critical care unit Padre Hurtado Hospital between may and december 2000. Results: 15 patients were studied, 73% male, median age 1 month 22 days (range 15 days to 4 months 23 days). Six were aged less than 1 month and median gestational age was 40 weeks (range 26-40). Most frequent clinical manifestationes were cough 15/15, cyanosis 13/15, and apnoea 3/15. the median white blood count (WBC) was 19,600/mm3 (11,060-120,000) and median lymphocyte count 11,013/mm3. WBC was normal in 7. The mean stay in PICU was 4 days. 4 patients needed conventional mechanical ventilation, 2 high frequency oscillatory ventilation and one inhaled nitric oxide. 2 patients died, in one autopsy confirmed pulmonary hypertension. Conclusion: Bordetella pertussis infection may be fatal in early life and clinical presentation may be atypical. The most serious complication is the development of cardiogenic shock secondary to pulmonary hypertension. In the course of pertussis the presence of tachycardia, hyperleucocitosis and progressive respiratory distress should alert the physician to the possibility of pulmonary hipertension. Early diagnosis is essential for aggressive therapy to be instituted because otherwise the evolution is fulminant and fatal in this group of patients.