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- W2914596647 abstract "Peripheral blood film review is an integral part of the evaluation process in identifying Bordetella pertussis infection in children. Commonly, pertussis infection presents with prominent lymphocytosis. In addition, small mature lymphocytes with hyperchromatic cleaved nuclei are found in the blood film. High levels of leucocytosis and pulmonary hypertension are known to be associated with poor outcomes and exchange transfusion may be utilised to decrease the numbers of circulating white cells. Literature suggests that pertussis cases with WCC greater than 25×109/L and a neutrophil to lymphocyte ratio greater than 1.0 indicate an increased risk of death.1 We discuss a case of pertussis that presented in a regional laboratory with a WCC of 120×109/L and the neutrophil count higher than the lymphocyte count. The film appeared septic with neutrophil toxic granulation and only scant numbers of cleaved lymphocytes. The neutrophil to lymphocyte ratio was 1.3 on presentation but rapidly increased to 2.4 within 24 hours. The patient was transferred to the recently opened Perth Children’s Hospital and exchange transfusion was performed. We postulate the importance of reporting the neutrophil to lymphocyte ratio as a prognostic parameter, assisting in early recognition of children at risk of fatal pertussis infection." @default.
- W2914596647 created "2019-02-21" @default.
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- W2914596647 date "2019-02-01" @default.
- W2914596647 modified "2023-09-24" @default.
- W2914596647 title "Pertussis prognostic parameters" @default.
- W2914596647 doi "https://doi.org/10.1016/j.pathol.2018.12.358" @default.
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