Objective: To report early blood exchange transfusion in malignant pertussis and a favorable clinical outcome.
Setting: A pediatric intensive care unit in a tertiary hospital in Geneva, Switzerland.
Design: A descriptive case report.
Patient: An 8-wk-old girl was diagnosed with malignant pertussis (extreme leukocytosis, seizures, pneumonia, and secondary severe hypoxic respiratory failure associated with pulmonary hypertension). After administration of a one-volume blood exchange transfusion, a rapid decrease in white blood cell count (from 119,000/mm(3) to 36,500/mm(3)) was observed and followed by clinical improvement and favorable outcome despite the initial presence of all described risk factors associated with a high mortality.
Conclusion: The use of exchange blood transfusion early in the course of the disease might help to prevent a fatal outcome of malignant pertussis.