HEMATOLOGIC FINDINGS IN PERTUSSIS

Abstract

Patients infected with Bordetella pertussis frequently exhibit leukocytosis and lymphocytosis. Eosinophilia has been noted less frequently. Peripheral blood counts were analyzed in 17 patients with laboratory confirmed pertussis (culture +14, fluorescence +3) to look for other hematological abnormalities. Fifteen of 17 patients were below the age of one year; others were 4 and 35 years old.

Leukocytosis (> 15,000/cmm) was noted in 12 patients; 11 of these also had lymphocytosis (>10,000/cmm). Five patients were neutropenic (ANC< 1500/cmm). Eosionophilia (> 500/cmm) was noted in 6 patients. No patient had a hemoglobin < 10 gm/dl. The platelet count was normal (150,000-400,000/cmm) in 15 patients and elevated in 2. Previous investigators have described the lymphocytes in pertussis as being small and mature. In contrast, 5 patients in this study had immature lymphocytes that were medium sized with scanty cytoplasm, loose nuclear chromatin and one or more nucleoli on light microscopy. While the previously described lymphocytosis and eosinophilia were seen, the hematologic findings in pertussis should be expanded to include neutropenia and the presence of immature lymphocytes.

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