Clinical Profile of Critical Pertussis in Children at a Pediatric Intensive Care Unit in Northern India

ABSTRACT

Objective: To delineate the clinical profile, complications, intensive care needs, andpredictors of mortality in children with critical pertussis. Methods: Retrospective analysis ofcase records of children in the pediatric intensive care unit of a tertiary-care hospital, with adiagnosis of critical pertussis over 3 years. Diagnostic criteria included CDC case definitionand confirmation by polymerase chain reaction (PCR), when available. Survivors and non-survivors were compared to identify predictors of mortality. Results: 36 records wereanalysed, most cases were infants (31, 86.1%). 10 (27.7%) were (below 6 weeks of age). Inthe rest, 16 (61.5%) were partially immunized or unimmunized against pertussis. Rapidbreathing (88.9%), paroxysmal cough (86.1%) and apnea (41.7%) were common presentingcomplaints. Hypoxemia (97.2%), hyperleukocytosis (61.1%) and encephalopathy (52.8%)were common complications. Intensive care needs were mechanical ventilation in 11(30.6%), vasoactive support in 7 (19.4%) and exchange transfusion in 3 (8.3%). Femalegender, apnea, hyperleukocytosis, encephalopathy, need for vasoactive support, andmechanical ventilation predicted mortality. Conclusion: Pertussis demands attention due toits varied presentation, increased complications and higher mortality.