Anesthésie et recherche clinique
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Anesthesia in a Young Infant with Unrecognized Pertussis Infection - Mild Cold or Severe Infection? Reinforcing the Debate

Joana Guimaraes, Jacinta Sa, Pedro Pina and Humberto Machado

Preoperative anesthetic evaluation for pediatric elective surgery includes the assessment of upper respiratory tract infection symptoms. In this case report, a 34-days-old term infant scheduled to elective unilateral inguinal hernia repair had an undiagnosed pertussis infection although the child presented mild symptoms. Especially in infants with less than 4 months pertussis should be suspected when the child presents a rhinorrhoea that remains watery associated with cough that is not improving, usually without fever. The impact of anesthesia in the progression and severity of the disease is unknown. Given the epidemiological context of pertussis infection resurgence on developed countries, there should be a low threshold of suspicion in the preoperative anesthetic evaluation given the risk of serious complications. Debate about surgical delay and impact of anesthesia in young infants is far from over and should include new questions about poor clinical presentation of severe respiratory diseases in these children.