Lymphocyte morphology supports early diagnosis of Bordetella pertussis infection in neonates

Excerpt

A 42-day-old infant was admitted to our pediatric intensive care unit (PICU) for respiratory distress. The complete blood count analysis showed an important lymphocytosis (38.48 × 10⁹/L); the peripheral blood smear evaluation revealed small and deeply clefted lymphocytes with mature chromatin morphology suggestive of Bordetella pertussis infection (Fig. 1a–d). Azithromycin was started. Two days later microbiologists confirmed the diagnosis by real-time polymerase chain reaction (PCR). The infant was supported with invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO) because of the persistence of severe hypoxia and pulmonary hypertension; nevertheless, he developed progressive multiorgan failure and died on the 5th day following admission.

…