Retinal haemorrhage in infants with pertussis

Arch Dis Child. 2017 Dec;102(12):1158-1160. doi: 10.1136/archdischild-2017-313380. Epub 2017 Sep 22.


Aims: It has been hypothesised that paroxysmal coughing in infantile pertussis (whooping cough) could produce retinal haemorrhages identical to those seen in abusive head trauma. We aimed to test this hypothesis.

Methods: This is a prospective study of infants hospitalised with pertussis in Auckland, New Zealand, from 2009 to 2014. The clinical severity of pertussis was categorised. All infants recruited had retinal examination through dilated pupils by the paediatric ophthalmology service using an indirect ophthalmoscope.

Results: Forty-eight infants with pertussis, aged 3 weeks to 7 months, were examined after a mean of 18 days of coughing. Thirty-nine had severe pertussis and nine had mild pertussis. All had paroxysmal cough, and all were still coughing at the time of examination. No retinal haemorrhages were seen.

Conclusions: We found no evidence to support the hypothesis that pertussis may cause the pattern of retinal haemorrhages seen in abusive head trauma in infants.

Keywords: abusive head trauma; child abuse; retinal haemorrhage; shaken baby syndrome; whooping cough.

Publication types

  • Multicenter Study

MeSH terms

  • Cough / complications*
  • Cough / epidemiology
  • Cough / microbiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • New Zealand / epidemiology
  • Ophthalmoscopy
  • Prospective Studies
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / epidemiology
  • Retinal Hemorrhage / etiology*
  • Whooping Cough / complications*
  • Whooping Cough / epidemiology