AI Article Synopsis
- Bordetella pertussis infection leads to significant mortality in young, unvaccinated infants, with nearly all deaths in the U.S. occurring in infants under 4 months old.
- Histopathological analysis of autopsy samples from affected infants shows severe lung damage, with key features like necrotizing bronchiolitis and extensive leukocyte accumulation in the lungs.
- Findings suggest that pertussis pneumonia in these infants causes acute pulmonary complications, highlighting the need to consider pertussis as a cause in similar cases of infant death and respiratory distress.
Article Abstract
Background: Each year, Bordetella pertussis infection causes an estimated 294,000 deaths worldwide, primarily among young, nonvaccinated children. Approximately 90% of all deaths due to pertussis in the Unites States occur in young infants. These children often develop intractable pulmonary hypertension; however, the pathophysiologic mechanism responsible for this complication has not been well characterized, and there have been no detailed descriptions of the pathology of this disease since the 1940s.
Methods: Respiratory tissue samples obtained at autopsy from 15 infants aged
Results: The pulmonary histopathologic examination of the samples revealed a descending infection dominated by necrotizing bronchiolitis, intra-alveolar hemorrhage, and fibrinous edema. All samples had marked leukocytosis, and most showed luminal aggregates of abundant leukocytes in small pulmonary arteries, veins, and lymphatics. A novel immunohistochemical stain for B. pertussis revealed abundant extracellular bordetellae in cilia of the trachea, bronchi, and bronchioles, as well as intracellular bacteria and antigens in alveolar macrophages and ciliated epithelium.
Conclusions: Pertussis should be suspected in any infant death associated with marked leukocytosis, bronchopneumonia, or refractory pulmonary hypertension, particularly in children aged
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http://dx.doi.org/10.1086/589753 DOI Listing Publication Analysis
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