Pertussis: the resurgence of a public health threat

  • Jackeline Aparecida Grando Della Torre Pediatrics Institute - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP
  • Gabriel Nuncio Benevides Pediatrics Institute - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP
  • Ana Maria Andrello Gonçalves Pereira de Melo Pediatrics Division - Hospital Universitário - Universidade de São Paulo, São Paulo/SP
  • Cristiane Rúbia Ferreira Anatomy Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP
Keywords: Bordetella pertussis, Respiratory Insufficiency, Immunization, Leukocytosis, Autopsy

Abstract

Pertussis is an acute and very contagious pulmonary disease, clinically characterized by periods of coughing and paroxysms that may cause death. The disease afflicts mainly the pediatric population and is life threatening to children under the age of 1 year. Since the beginning of the second millennium, the number of cases of pertussis has increased, menacing public health, despite the availability of the pertussis vaccine. The resurgence of the disease among adults and older children creates a reservoir of infection that will afflict the unimmunized or incompletely immunized children. As newborns and infants show the highest mortality rate, immunization during pregnancy is a new strategy to reduce the burden of pertussis. The authors report the case of a newborn that presented respiratory distress accompanied by marked leukocytosis. Bronchiolitis was the initial diagnostic hypothesis, but the clinical picture became typical of pertussis when paroxysmal coughing ensued. Isolation of the Bordetella pertussis and antigenic demonstration by polymerase chain reaction were positive from respiratory secretion. Despite appropriate antibiotic therapy and intensive care management the child died and the autopsy showed characteristic diagnostic findings. The authors call attention to this diagnosis when facing respiratory failure among young children, mainly in the presence of marked leukocytosis. Thorough research on the immunization status of the patient’s social environment is of crucial importance.

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Published
2015-06-30
How to Cite
Della Torre, J., Benevides, G., Melo, A. M., & Ferreira, C. (2015). Pertussis: the resurgence of a public health threat. Autopsy and Case Reports, 5(2), 9-16. Retrieved from http://www.revistas.usp.br/autopsy/article/view/107035
Section
Article / Autopsy Case Report