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Pertussis: Severe clinical presentation in pediatric intensive care and its relation to outcome*
- Source :
- Pediatric Critical Care Medicine. 8:207-211
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- Objective: To describe our institutional experience in the management of infants and children with pertussis admitted during a 20-yr period (January 1985 through December 2004) and also to study the relation between method of presentation and outcome. Setting: Pediatric intensive care unit in a university-affiliated tertiary pediatric hospital in Melbourne, Australia. Design/Methods: Retrospective review of medical records and radiology reports of patients with a diagnosis of pertussis identified from the pediatric intensive care unit database. Results: A total of 49 patients (median age, 6 wks; interquartile range, 4–8 wks) required 55 admission episodes to the pediatric intensive care unit. Main reasons for admission were apnea with or without cough paroxysms (63%), pneumonia (18%), and seizures (10%). None of the infants had completed the primary course of immunization, and 94% had not received a single dose of pertussis vaccine. Infants presenting with pneumonia presented earlier (p = .001), had longer intensive care stay (p = .007), higher white cell count (p ≤ .001), lower Pao2 at admission (p = .020), and higher mortality. Six infants out of seven needing circulatory support died (including all four treated with extracorporeal membrane oxygenation), and all deaths (n = 7) occurred in infants who had pneumonia at presentation. Conclusion: Patients with pertussis, presenting as apnea (with or without cough paroxysms), treated in the pediatric intensive care unit had 100% survival. However, pneumonia as the main reason for admission and the need for circulatory support is associated with a very poor outcome. A deeper understanding of the molecular basis of Bordetella pertussis and its relation to the human host might offer means for future therapies.
- Subjects :
- Bordetella pertussis
Pediatrics
medicine.medical_specialty
Whooping Cough
medicine.medical_treatment
Intensive Care Units, Pediatric
Critical Care and Intensive Care Medicine
Interquartile range
Intensive care
Outcome Assessment, Health Care
Pneumonia, Bacterial
Extracorporeal membrane oxygenation
medicine
Humans
Retrospective Studies
Pertussis Vaccine
Pediatric intensive care unit
biology
business.industry
Medical record
Infant
biology.organism_classification
medicine.disease
Pneumonia
Child, Preschool
Pediatrics, Perinatology and Child Health
Pertussis vaccine
business
medicine.drug
Subjects
Details
- ISSN :
- 15297535
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Pediatric Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....02c1e40ae6bfce603af931ef24a66369