1- Unidade de Doenças Infecciosas, Pediatria Médica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2- Unidade de Neurologia Pediátrica Pediatria Médica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
3- Unidade de Cuidados Intensivos Neonatais Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Publicação em versão integral, Port J Pediatr 2019;50:53-6 DOI: https://doi.org/10.25754/pjp.2019.12999
Abstract: Newborn, 25-day-old admitted for paroxysmal cough, moaning, bilateral crackling with apnoea and acute respiratory failure. Chest X-ray showed an infiltrate in the left hemithorax. Blood tests showed 38,000/μL leukocytes, 19,000/μL lymphocytes and C-reactive protein of 27.4 mg/L. The patient was started on cefuroxime and gentamicin and needed mechanical ventilation. Polymerase chain reaction for Bordetella pertussis was positive and azithromycin was associated. He did not undergo exchange transfusion. On the third day, the newborn initiated clonic movements of the limbs. The electroencephalogram showed epileptiform activity in the posterior temporal regions. The cerebrospinal fluid had 40 cells/μL and 254 mg/dL proteins, and the magnetic resonance showed hyperintensity of the frontoparietal white matter and thalamus. Evolution was favourable under phenobarbital and phenytoin. Within the family, which was a supporter of the antivaccine movements, no family member was vaccinated. Pertussis encephalopathy is a rare but feared complication of Bordetella pertussis infection. An exchange transfusion may improve the prognosis. Universal vaccination, particularly in pregnant women, is an important public health measure for the protection of vulnerable groups.
Palavras Chave: Brain Diseases/aetiology; Brain Diseases/therapy; Bordetella pertussis; Infant, Newborn; Whooping Cough/complications; Whooping Cough/ therapy