Presentation
We present a rare case of acute epiglottitis in a fully vaccinated child due to nontypeable H. influenzae and discuss the clinical presentation and management. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Pneumonia Symptoms of pneumonia usually include: Fever and chills Cough Shortness of breath or difficulty breathing Sweating Chest pain Headache Muscle pain or aches Excessive tiredness Bloodstream infection Symptoms of bloodstream infection usually include [cdc.gov]
Osteomyelitis - swelling, inflammation and pain over the affected bone. How is it spread? Hib bacteria can live harmlessly in the throat of healthy people. [health.nsw.gov.au]
A 48-year-old female presented to the emergency department with a 3-day history of lower abdominal pain and fever. On physical examination she was tachycardic, hypotensive and had fundic tenderness to palpation. [ncbi.nlm.nih.gov]
[…] depending on the specific infection: For otitis media (middle ear infection) unusual irritability difficulty sleeping or staying asleep tugging or pulling at one or both ears fever fluid draining from ear(s) loss of balance hearing difficulties ear pain [childrenshospital.org]
- Splenectomy
Before and after splenectomy Hib is an uncommon cause of post-splenectomy sepsis in adults and children. Children older than 2 years who have received all scheduled doses of Hib vaccine do not require a booster dose after splenectomy. [www2.health.vic.gov.au]
It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia [ncbi.nlm.nih.gov]
[…] the respiratory tract, Children with chronic otitis, Patients with confirmed humoral immuno-deficiencies (IgG-2-deficiency, IgA-deficiency), Patients with confirmed granulocyte deficiencies, Patients under chemo or cytostatic therapy, Children after splenectomy [ibl-international.com]
- Malaise
A 58 year-old man was treated by endograft placement for a presumed penetrating aortic ulcer after having symptoms of abdominal pain and malaise for one month. He presented to our institution 11 days after endograft placement with septic physiology. [ncbi.nlm.nih.gov]
Reported adverse effects were largely gastrointestinal in nature, although increased dyspnoea or general malaise were also commonly reported; none of these were found to be directly attributable to the oral vaccine. [doi.org]
- Rigor
[…] data on the consequences of the disease 15, 17 18 19 and the lack of agreement on the medical factors that are most predictive of poor outcomes. 1, 10 11 12, 15 The chief objective of the present study was to address these issues with the use of more rigorous [nejm.org]
Musculoskeletal
- Arthritis
To the best of our knowledge, this is the fourth reported case of H. influenzae serotype f septic arthritis in adults. [ncbi.nlm.nih.gov]
Hib causes septic arthritis and cellulitis in children younger than 2 years. Hib septic arthritis also occurs in adults. Neonatal infection: Often due to non-typeable H. influenzae, which colonises the maternal genital tract. [patient.info]
Ears
- Hearing Problem
Symptoms may include: Abnormal grouchiness Trouble sleeping or staying asleep Tugging or pulling at one or both ears Fever Fluid draining from an ear or ears Loss of balance Hearing problems Ear pain Loss of appetite Conjunctivitis This is an inflammation [urmc.rochester.edu]
Neurologic
- Neck Stiffness
Older children with meningitis typically have neck stiffness and sensitivity to light. Children with epiglottitis may have breathing difficulties and be dribbling and anxious. [healthywa.wa.gov.au]
In older children and adults symptoms of meningitis include: headache fever vomiting neck stiffness and joint pains drowsiness or confusion discomfort on looking at bright lights. [dhhs.tas.gov.au]
Workup
[…] presence of cellulitis Joint, lung, and sinus aspiration Transtracheal aspiration Tympanocentesis Pericardiocentesis Laparoscopy and tubal cultures in women: For suspected NTHi Culdocentesis and peritoneal fluid cultures in women: For suspected NTHi See Workup [emedicine.medscape.com]
Treatment
However, azithromycin treatment failures were reported in acute urethritis caused by H. influenzae strains considered susceptible to azithromycin. [ncbi.nlm.nih.gov]
Prognosis
Treatment and prognosis Mortality rates in patients with H. influenzae pneumonia have been reported as ranging around 10-42% Promoted articles (advertising) [radiopaedia.org]
Prognosis The sequelae following Hib meningitis may include deafness, convulsions and intellectual impairment. [patient.info]
We find a favorable prognosis for the majority of children who are treated for meningitis caused by H. influenzae type b. (N Engl J Med 1990; 323:1657–63.) [nejm.org]
The prognosis of uncomplicated Hib pneumonia and nonencapsulated H influenzae infections is usually good. [emedicine.medscape.com]
Etiology
Tabs Content Clinical Overview Diagnosis Indications for Testing Identify etiologic agent in pneumonia, meningitis, cellulitis, septic arthritis Laboratory Testing CDC testing recommendations Rapid antigen detection tests are available – utility is questionable [arupconsult.com]
The authors suggest that this species should be taken into account as the etiologic agent of peritoneal dialysis-associated peritonitis. Targeted antimicrobial therapy should be based on local antibiotic resistance patterns. [ncbi.nlm.nih.gov]
Epidemiology
Seven epidemiologically unrelated cases of invasive Haemophilus influenzae type a (Hia) disease were identified in First Nations communities of Northwestern Ontario, Canada, in 2004-2008. In all cases, Hia was isolated from blood. [ncbi.nlm.nih.gov]
Pathophysiology
In this article, the author reviews the clinical manifestations and pathophysiology of H influenzae infection, with emphasis on the key features useful for making a timely diagnosis. [medlink.com]
[…] settings where the test may be helpful Assessing a patient's immunological (IgG) response to Haemophilus influenzae type B (HIB) vaccine Assessing immunity against HIB Aiding in the evaluation of immunodeficiency Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
Pathophysiology The nomenclature ( Haemophilus is Greek for "blood loving") acknowledges the fact that H influenzae requires 2 erythrocyte factors for growth: X (hemin) and V (nicotinamide-adenine-dinucleotide). [emedicine.medscape.com]
Prevention
Author information 1 Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan; Division of Infection Control and Prevention, Osaka [ncbi.nlm.nih.gov]
Prevention Invasive Hib disease can be prevented by giving the Hib vaccine to kids 2-18 months of age. [dshs.texas.gov]
How can Hib disease be prevented? The best way to prevent Hib disease is to ensure all children are vaccinated according to the National Immunisation Program Schedule (see below). [healthywa.wa.gov.au]
Vaccines can prevent Hib disease. CDC recommends routine Hib vaccination for all children younger than 2 years old. [cdc.gov]