Severe Pertussis with pulmonary hypertension: cardiorespiratory improvement after exchange transfusion

Abstract

Introduction: Severe Bordetella pertussis infection in infancy is associated with high mortality, in spite of vital advanced support. Refractory pulmonary hypertension (PHT) is a bad prognostic condition associated, whose etiology is poorly understood. Hyperleukocytosis is an identified risk factor for PHT, in which the use of techniques to reduce the leukocyte mass such as exchange transfusion is suggested. 

Case report: A 4 months-old girl not vaccinated before, with severe Pertussis developing respiratory and myocardial failure, with severe PHT and a leukocyte count of 78800/UL. After conventional therapy failed, we used exchange transfusion showing respiratory and hemodynamic improvement temporally. We suggest that early exchange transfusion in severe Pertussis with hyperleukocytosis is an efficient therapy.