Severe pertussis and hyperleukocytosis: is it time to change for exchange?

Background: Pertussis is an important cause of infant death worldwide and continues to be a public health concern even in countries with high vaccination coverage. Severe (critical) pertussis with hyperleukocytosis is a severe form of the disease with up to 80% mortality rate. Attempts have been reported to reduce the white blood cell burden by exchange transfusion (ET) with conflicting conclusions.

Case Report: We report a case of critical pertussis in a neonate who was treated with ET, in view of a comprehensive literature review.

Results: The patient was discharged without any sequelae.

Conclusion: ET should be considered in all infants suffering from critical pertussis and hyperleukocytosis, even in secondary care community hospitals.