[Malignant pertussis and exchange transfusion]. / Coqueluche maligne et exsanguino-transfusion.
Arch Pediatr
; 22(1): 84-7, 2015 Jan.
Article
en Fr
| MEDLINE
| ID: mdl-25466784
ABSTRACT
CASE REPORT Malignant pertussis is a critical clinical state associated with fatal outcome in 70% of cases. The severity criteria are a lung infection with pulmonary hypertension and hyperleukocytosis usually above 50 G/L. We report the case of a 2.5-month-old girl hospitalized with critical pertussis in a pediatric intensive care unit. She had acute respiratory distress syndrome with pulmonary hypertension complicated by a bacterial secondary infection with Enterobacter cloacae managed by high-frequency oscillatory ventilation associated with pulmonary vasodilatation therapy. In the absence of clinical improvement and before considering extracorporeal life support, exchange transfusion was performed at day 9 to reduce hyperleukocytosis at 70 G/L. Exchange transfusion was successfully performed with a reduction of leukocytes to under 40 G/L followed by steady improvement of pulmonary function. Weaning from mechanical ventilation and discharge took place at day 23 and 38, respectively. COMMENTS:
Exchange transfusion should be considered in infants suffering from malignant pertussis with extreme leukocytosis before hemodynamic failure to improve the survival prognosis.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Recambio Total de Sangre
/
Tos Ferina
/
Leucocitosis
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Idioma:
Fr
Revista:
Arch Pediatr
Año:
2015
Tipo del documento:
Article