Pertussis compared with viral respiratory tract illnesses in neonates

Article Outline

• Copyright

Using polymerase chain reaction techniques to confirm the diagnosis of pertussis and a variety of tests to confirm the diagnosis of viral respiratory tract infections in neonates, clinical features of the two groups were studied retrospectively. Comparing 33 cases each of pertussis and non-pertussis viral disease, investigators found certain symptoms (paroxysmal cough, apnea, cyanotic spell) and severe course (prolonged hospitalization, need for oxygen, and use of respiratory supportive care upon discharge) more common in pertussis cases. An additional important clue to the microbiologic diagnosis was probable acquisition – from ill parent (82% for pertussis vs. 50% for non-pertussis cases) and from ill sibling(s) (30% for pertussis vs. 75% for non-pertussis cases). Thinking of the diagnosis of pertussis in the absence of a whoop is a critical first step in neonates in order to anticipate a prolonged and complicated course for which supportive care may be lifesaving, including mechanical ventilation when needed and consideration of leukopheresis in those who develop critical pulmonary hypertension.