Indian pediatrics · 2026
Clinical Profile, Outcome and Risk Factors for Mortality Among Children Admitted with Critical Pertussis: An Ambispective Study.
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Kacha Asruti, Thakkar Pareshkumar Amrutlal, Gandhi Dhairya, Viswanathan Rajlakshmi, Choudhary Manohar Lal, Shukla Omprakash, Aiyer Sheila
Аннотация
OBJECTIVE: To study the clinical and microbiological profile, outcome, and risk factors for mortality in children with critical pertussis.
METHODS: An ambispective study included children admitted to the pediatric intensive care unit diagnosed with critical pertussis (n = 75) between November 2022 and June 2023. Diagnosis was confirmed by real-time polymerase chain reaction (PCR) and outcomes were recorded.
RESULTS: Out of 75 cases, 57 (76%) tested positive for Bordetella infection (34 B. pertussis, 23 other species). Nearly half were children < 3.5 months of age. Common clinical features were fever, paroxysmal cough and tachypnea. Chest radiograph in all cases revealed diffuse infiltrates. Complications included hypoxemia (n = 69, 92%), shock (n = 41, 54.7%), encephalopathy (n = 38, 50.7%) and seizures (n = 29, 38.7%). Sixty-three (84%) patients needed mechanical ventilation and 38 (50.7%) expired. Presence of shock was identified as an independent risk factor for mortality (aOR (95%CI) 7.63 (2.11, 27.59); P = 0.002).
CONCLUSION: Critical pertussis commonly presents with severe pneumonia and can be caused by B. pertussis and other Bordetella species. Presence of shock is associated with a high risk of mortality in children with critical pertussis.
METHODS: An ambispective study included children admitted to the pediatric intensive care unit diagnosed with critical pertussis (n = 75) between November 2022 and June 2023. Diagnosis was confirmed by real-time polymerase chain reaction (PCR) and outcomes were recorded.
RESULTS: Out of 75 cases, 57 (76%) tested positive for Bordetella infection (34 B. pertussis, 23 other species). Nearly half were children < 3.5 months of age. Common clinical features were fever, paroxysmal cough and tachypnea. Chest radiograph in all cases revealed diffuse infiltrates. Complications included hypoxemia (n = 69, 92%), shock (n = 41, 54.7%), encephalopathy (n = 38, 50.7%) and seizures (n = 29, 38.7%). Sixty-three (84%) patients needed mechanical ventilation and 38 (50.7%) expired. Presence of shock was identified as an independent risk factor for mortality (aOR (95%CI) 7.63 (2.11, 27.59); P = 0.002).
CONCLUSION: Critical pertussis commonly presents with severe pneumonia and can be caused by B. pertussis and other Bordetella species. Presence of shock is associated with a high risk of mortality in children with critical pertussis.