Unrecognized maternal peripartum pertussis with subsequent fatal neonatal pertussis

Background: Pertussis is an illness that is frequently unrecognized in adults. The source of pertussis infection in young infants is usually an adult and most frequently a parent. Case: A woman developed severe paroxysmal coughing requiring hospitalization 6 days before delivery. She was thought to have viral pneumonia and reactive airway disease. One week after birth, her infant developed a similar illness and also required hospitalization. The infant's respiratory illness progressively worsened, resulting in death. Conclusion: Although the clinical findings were typical for pertussis in both the mother and infant, pertussis was not considered and therefore neither received specific antimicrobial therapy. Patients with illnesses suggestive of pertussis, and their contacts, should be treated with erythromycin before the results of laboratory studies are known, in order to prevent serious and fatal illnesses in infants.(Obstet Gynecol 1993;82:691-3)