The White Blood Cell Count and the Erythrocyte Sedimentation Rate in Pertussis

Abstract

SUMMARY The white blood cell count and the erythrocyte sedimentation rate were studied in 180 hospital patients with a clear‐cut diagnosis of pertussis. In children below 6 months, the white blood cell picture favoured a diagnosis of pertussis in only one out of every four or five cases during the first 3 weeks of the disease, but not later. In children over 6 months, absolute leucocytosis and lymphocytosis were noted in the majority during the first 2 weeks of the disease (leucocytosis in 63 % and lymphocytosis in 71 %). During the third and fourth weeks changes in the white cells supported the diagnosis of pertussis in 80% and 50%, respectively. Marked leucocytosis (more than 50,000 leucocytes per mm3. of blood) was noted in 8 cases. I n uncomplicated pertussis the erythrocyte sedimentation rate is usually normal or subnormal and does not appear to vary with the patient's age or the week of the disease.

The Mitogenic Effect of the Lymphocytosis Promoting Factor from Bordetella Pertussis on Human Lymphocytes

“…These results are consonant with the findings in the murine system where responsiveness of lymphocytes to LPF was also shown to be unrelated to presensitization to antigen (5). Although lymphocytosis often accompanies clinical pertussis, except in infants under 6 mo of age, blast cells are not found in the blood (1). It has been shown in experimental animals that the increase in ciruclating lymphocytes is the result of redistribution of cells and not to proliferation (18).…”

“…The association of peripheral blood lymphocytosis with clinical pertussis (whooping cough) has long been known (1). Both intact Bordetella pertussis organiSms and culture supernatant fluids induce lymphocytosis in mice and many other experimental animals (2).…”

Clinical Findings in Bordetella pertussis Infections: Results of a Prospective Multicenter Surveillance Study

“…3 The WBC count was unrelated to age and did not correlate with the subsequent clinical course. In contrast, Lagergren 25 found marked differences in leukocyte and lymphocyte counts when comparing 39 hospitalized children Ͻ6 months of age, with 52 patients 6 months to 12 years of age during the first 2 weeks after admission. In the young age group, 33% and 36% had leukocyte counts Ն15 000/mm 3 and lymphocyte counts Ն11 000/mm, 3 compared with 71% and 63% in the older age group, respectively.…”

“…Leukocytosis attributable to lymphocytosis was recognized as a hallmark of pertussis infection 100 years ago. 25 It is attributable to pertussis toxin, and it is the only known systemic manifestation of this toxin. 16 There are only a few detailed descriptions of leukocyte and/or lymphocyte values in patients with pertussis.…”

Serum IgA antibody to Bordetella pertussis as an indicator of infection

“…Only children whose clinical diagnosis had been supported by culture of the pathogen or by haematological or serological findings, were included in this study. The haematological criteria of Lagergren (1963) were adopted: in children aged < 6 months, a leukocytosis greater than 20 x lo9 WBC/L or a lymphocyte count of at least 15 x 109/L is suggestive of pertussis infection; in older children the figures are 15 x 109/L and 11 x 109/L, respectively. A four-fold rise of the bacterial agglutination titre or a single titre of 256 or greater were taken as serological evidence of infection.…”