ArticleAnnals of intensive care2021
Malignant pertussis in infants: factors associated with mortality in a multicenter cohort study.
Article in Annals of intensive care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Variability in the Diagnostic Criteria for Severe Pertussis: A Systematic Review.JAMA network open · 2026Pooled it
- Pertussis infection in critically ill infants: meta-analysis and validation of a mortality score.Critical care (London, England) · 2025Pooled it
- Therapeutic Role of Hydroxyurea in Paediatric Hydroxyurea Pertussis:Sultan Qaboos University medical journal · 2025Pooled it
- Early risk stratification for ICU admission in hospitalized children with pertussis: development and internal validation of an admission-time prediction model.BMC infectious diseases · 2026Article
- Therapeutic leukapheresis with severe pertussis: evaluating efficacy, feasibility, and safety.BMC pediatrics · 2026Article
- Article
- An old foe comes swooping back: Whooping cough resurgence-Okay, now what?PLoS pathogens · 2026Article
- Hypercapnia as a Key Mechanism in the Development of Pulmonary Hypertension in Malignant Pertussis: A Case Report.Respirology case reports · 2026Article
- Parent-driven transmission, off-label SMZ-TMP, and severe pertussis prediction in infants under 2 months: a real-world observational cohort of 527 cases.Frontiers in pediatrics · 2026Article
- Clinical and laboratory characteristics of criticalFrontiers in pediatrics · 2026Article
- A contemporary overview of severe community-acquired bacterial infections in pediatric intensive care units.Annals of intensive care · 2026Article
- Risk factors for severe pertussis in children and the application of exchange transfusion.Pediatric research · 2026Article
- Clinical characteristics and prognosis of exchange transfusion in infants with severe pertussis.BMC pediatrics · 2025Article
- Article
- Clinical and Epidemiological Characteristics of Pediatric Pertussis Cases: A Retrospective Study from Southeast Romania.Antibiotics (Basel, Switzerland) · 2025Article
- Risk factors and mortality in children with severe pertussis: the role of exchange transfusion in a PICU.Italian journal of pediatrics · 2025Article
- Article
- Interferon lambda signaling in neutrophils enhances the pathogenesis of Bordetella pertussis infection.Journal of leukocyte biology · 2025Article
- Critical pertussis infection in the paediatric intensive care unit: A case series in an outbreak.The Southern African journal of critical care : the official journal of the Critical Care Society · 2025Article
- Severe pertussis in infants: a scoping review.Annals of medicine · 2024Article
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Authors and funding
14 authors at 10 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalignant pertussis (MP) affects young infants and is characterized by respiratory distress, perpetual tachycardia and hyperleukocytosis up to 50 G/l, leading to multiple organ failure and death in 75% of cases. Leukodepletion may improve prognosis. A therapeutic strategy based on leukodepletion and extracorporeal life support (ECLS) according to different thresholds of leucocytes has been proposed by Rowlands and colleagues. We aimed at identifying factors associated with death and assess whether the respect of the Rowlands' strategy is associated with survival.
methodsWe reviewed all MP infants hospitalized in eight French pediatric intensive care units from January 2008 to November 2013. All infants younger than 3 months of age, admitted for respiratory distress with a diagnosis of pertussis and WBC count ≥ 50 G/l were recorded. Evolution of WBC was analyzed and an optimal threshold for WBC growth was obtained using the ROC-curve method. Clinical and biological characteristics of survivors and non-survivors were compared. Therapeutic management (leukodepletion and/or ECLS) was retrospectively assessed for compliance with Rowlands' algorithm (indication and timing of specific treatments).
resultsTwenty-three infants were included. Nine of 23 (40%) died: they presented more frequently cardiovascular failure (100% vs 36%, p = 0.003) and pulmonary hypertension (PHT; 100% vs 29%, p = 0.002) than survivors and the median [IQR] WBC growth was significantly faster among them (21.3 [9.7-28] G/l/day vs 5.9 [3.0-6.8] G/l/day, p = 0.007). WBC growth rate > 12 G/l/day and lymphocyte/neutrophil ratio < 1 were significantly associated with death (p = 0.001 and p = 0.003, respectively). Ten infants (43%) underwent leukodepletion, and seven (30%) underwent ECLS. Management following Rowlands' strategy was associated with survival (100% vs 0%; p < 0.001, relative risk of death = 0.18, 95%-CI [0.05-0.64]).
conclusionsA fast leukocyte growth and leukocytosis with neutrophil predominance during acute pertussis infection were associated with death. These findings should prompt clinicians to closely monitor white blood cells in order to early identify infants at risk of fatal outcome during the course of malignant pertussis. Such an early signal in infants at high risk of death would increase feasibility of compliant care to Rowlands' strategy, with the expectation of a better survival.
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