Pertussis in neonates
C. D. Christie and R. S. Baltimore
Department of Pediatrics, Yale University School of Medicine, New Haven, Conn.
Despite the increasing prevalence of pertussis in young adults and infants,
reports of maternal-neonatal pertussis are rare. Our study involves three
neonates who apparently acquired pertussis from their adolescent mothers.
The diagnosis of pertussis was initially missed in all of the patients. The
mothers had mild respiratory disease. All three newborns presented with
life-threatening coughing and choking spells without a characteristic
inspiratory whoop. Two neonates had apnea, bradycardia, cyanosis, and
unresponsiveness, but were without the initial lymphocytosis that is
distinctive of pertussis. These two neonates had a clinical course that was
consistent with the historic "100-day-cough." They required prolonged
ventilatory support and hospitalization at a high cost. The other neonate
had a terminal pulmonary hemorrhage. Strategies for the early diagnosis,
treatment, and prevention of this potentially lethal disease in neonates
are discussed.
