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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


SERRA, Alberto; GUTIERREZ, Carmen  and  MENCHACA, Amanda. Tos convulsa grave y su correlación anatomopatológica. Arch. Pediatr. Urug. [online]. 2013, vol.84, n.2, pp.136-142. ISSN 1688-1249.

Summary  Introduction: whooping cough is a bacterial infection of the respiratory tract caused by Bordetella pertussis. In the pre-vaccination era this was an endemic illness, with peaks reported every 2 to 5 years. After vaccination became widespread, incidence decreased 150 times. In Uruguay in 2011 there was an increase in in the number of cases of whooping cough, with more patients receiving treatment in Intensive Care and more deaths. Objective: describe 3 cases of patients who suffered from a whooping cough and died in Intensive Care Units between October and November 2011 and findings from anatomic pathology. Three cases are described that presented paroxysmal coughing syndrome with respiratory failure that required ventilator support. In all three cases Bordetella pertussis infection was confirmed. All of them presented severe leukocytosis that required blood transfusion and developed severe pulmonary hypertension with cardiogenic shock and renal failure with anuria. In the anatomic pathology of all three patients it was noted that extensive myocardia necrosis was present, as well as acute tubular necrosis and neuronal necrosis with brain edema. Conclusion: whooping cough has reemerged in the past few years, being especially serous in patients up to 6 months old. It is notable how evolution and presentation are stereotyped with refractory hypoxemia and HP that lead to cardiovascular collapse.


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