Incidence of Invasive Bacterial Disease in Children with Fever and Petechiae

PEDIATRICS ◽  
1984 ◽  
Vol 74 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Quoc Van Nguyen ◽  
Elizabeth A. Nguyen ◽  
Leonard B. Weiner
Keyword(s):  
Bacterial Infections ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Type B ◽  
Laboratory Findings ◽  
Life Threatening ◽  
Symptom Complex ◽  
Significant Disease ◽  
Single Laboratory ◽  
Normal Laboratory

The records of 129 patients admitted to the hospital with the findings of fever and petechiae were reviewed to determine the incidence of invasive bacterial disease in patients with this symptom complex. Twenty-six patients (20.2%) had culture-proven bacterial infections; 13 (11.1%) of the group had Neisseria meningitidis, eight had Haemophilus influenzae type B. No single laboratory test was sufficiently sensitive to detect all patients with life-threatening bacterial infections, but a combination of normal laboratory findings was highly specific for those without significant disease.

Adherence to Recommended Post-Splenectomy Immunizations to Reduce the Risk of Sepsis: The University of Washington Experience

2020 ◽  
Vol 35 (5) ◽  
pp. 405-410
Author(s):  
Nikita Pozdeyev ◽  
Arpit Patel ◽  
Paul S. Pottinger ◽  
Michael Leu ◽  
Thomas H. Payne
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
National Immunization ◽  
The Us ◽  
Control And Prevention ◽  
Life Threatening ◽  
Reduce Risk ◽  
The University

Immunizations against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b are recommended for patients undergoing splenectomy to decrease the risk of developing overwhelming infections. The authors sought to determine adherence to these recommendations by providers at UW Medicine. Regional immunization records for patients who underwent splenectomy between October 2015 and January 2019 were analyzed to measure compliance with immunization guidelines from the US Centers for Disease Control and Prevention (CDC). Among 253 patients who underwent splenectomy, 38 (15%) received all 7 immunizations against S pneumoniae, N meningitidis, and H influenzae type b recommended by the CDC; 95% of patients received at least 1 pneumococcal vaccine; 26% percent of patients did not receive MenB-4C vaccine. Many patients (3% to 10%) received redundant immunizations not in accordance with CDC recommendations. Development of state and national immunization registries and systems to improve adherence with post-splenectomy immunization guidelines may reduce risk for life-threatening infections.

scholarly journals Anatomical Asplenia in Cat Eye Syndrome:An Expansion of the Disease Spectrum

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
DeepakBabu Chellapandian ◽  
Adele Schneider
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Neisseria Meningitidis ◽  
Bacterial Infections ◽  
Type B ◽  
Disease Spectrum ◽  
Cat Eye Syndrome ◽  
Increased Risk ◽  
Life Threatening ◽  
Penicillin Prophylaxis

We report a patient with Cat eye syndrome (CES) associated with anatomical asplenia. To the best of our knowledge, there have been no prior reports of this association. Screening for asplenia in CES is potentially important, as asplenia places patients at increased risk for life-threatening bacterial infections. Hence patients with CES without a spleen may require the same routine precautions as any other asplenic patients, with penicillin prophylaxis and immunizations to protect against encapsulated organisms such asStreptococcus pneumoniae, Haemophilus influenzaetype b, andNeisseria meningitidis.

scholarly journals IgG2 immunodeficiency: association to pediatric patients with bacterial meningoencephalitis

2000 ◽  
Vol 58 (1) ◽  
pp. 141-145 ◽  
Author(s):  
XIOMARA ESCOBAR-PÉREZ ◽  
ALBERTO J. DORTA-CONTRERAS ◽  
MARIA TERESA INTERIÁN-MORALES ◽  
ELENA NORIS-GARCÍA ◽  
MARITZA FERRÁ-VALDÉS
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Infections ◽  
Pediatric Patients ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Igg Subclass ◽  
Type B ◽  
Igg Subclass Deficiency ◽  
Low Levels ◽  
Intravenous Gammaglobulin

An IgG subclass deficiency is often associated with bacterial infections. We studied four pediatric patients suffering from meningoencephalitis, two of them due to Streptococcus pneumoniae and two due to Haemophilus influenzae type b. Simultaneous diagnostic serum and cerebrospinal fluid samples were taken during income. The four subclasses of IgG and albumin were quantified in both biologic fluids by radial immunodiffusion. Very low levels of seric IgG2 with non detectable cerebrospinal fluid IgG2 were found in the patients. No intrathecal IgG subclass synthesis was found in two patients. One patient with S. pneumoniae had IgG3 intrathecal synthesis. Intrathecal IgG1, IgG3 and IgG4 synthesis was found in one patient suffering from H. influenzae according with reibergrams. Substitutive therapy with intravenous gammaglobulin was given to the patients as part of the treatment.

Management of Contacts of Children in Day Care With Invasive Haemophilus influenzae Type b Disease

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 939-941
Author(s):  
BARRY DASHEFSKY ◽  
ELLEN WALD ◽  
KARL LI
Keyword(s):  
Haemophilus Influenzae ◽  
Day Care ◽  
Care Setting ◽  
The United States ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
American Academy Of Pediatrics ◽  
Increased Risk

Haemophilus influenzae type b (HIB) is the most common cause of serious bacterial disease in children in the United States with 20,000 cases occurring annually. In 1979, it was convincingly reported that this pathogen could spread in households, resuiting in a significantly increased risk of subsequent disease in household contacts.1 Confusion resulting from changing recommendations of the Committee on Infectious Diseases of the American Academy of Pediatrics regarding rifampin prophylaxis for HIB disease2,3 and the recent advent of the HIB vaccine4 prompt this commentary on the management of contacts of children with invasive HIB disease with special emphasis on the day-care setting.

scholarly journals Beta-lactamase-negative ampicillin-resistant Haemophilus influenzae type b meningitis in partially immunized immunocompetent child: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Majid Ali Qureshi ◽  
Imran Asad ◽  
Adeel Chaudhary ◽  
Walid Abuhammour
Keyword(s):  
Emergency Department ◽  
Haemophilus Influenzae ◽  
Positive Outcome ◽  
Haemophilus Influenzae Type ◽  
Beta Lactamase ◽  
Type B ◽  
Significant Past Medical History ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Meningitis In Children

Abstract Introduction Haemophilus influenzae is a Gram-negative coccobacillus that can cause many different kinds of infection, ranging from mild ear infection to life-threatening diseases like epiglottitis and meningitis. Encapsulated type b Haemophilus influenzae was most commonly responsible for Haemophilus influenzae meningitis in children before introduction of Haemophilus influenzae conjugate vaccine. None or partially immunized children are acquiring meningitis owing to resistant strains of Haemophilus influenzae, namely beta-lactamase-negative ampicillin-resistant strain. Case presentation We reported the case of a 2-year-old Emirati boy who presented to our emergency department with fever, diarrhea, vomiting, and fluctuating levels of consciousness. He was developmentally normal with no significant past medical history, except he was partially immunized. Earlier, he had been treated for acute gastroenteritis with intravenous fluids and antiemetics in another hospital and was discharged. His parents escorted him to our emergency department as he became very drowsy. Examination revealed that he was in septic shock. He was immediately treated with oxygen, intravenous antibiotics, and fluids after performing septic workup. He was then shifted to intensive care unit. Blood culture and cerebrospinal fluid Gram stain confirmed diagnosis of beta-lactamase-negative ampicillin-resistant Haemophilus influenzae. He was started on intravenous ceftriaxone, acyclovir, and dexamethasone. He still spiked fever after 1 week. Therefore, ceftriaxone was replaced by meropenem. He recovered well with no sequelae. Conclusion This case highlights atypical presentation of life-threatening illness along with microbial resistance that had positive outcome due to timely diagnosis and aggressive management by a multidisciplinary team.

scholarly journals Changes in the epidemiology of epiglottitis following introduction of Haemophilus influenzae type b (Hib) conjugate vaccines in England: a comparison of two data sources

2005 ◽  
Vol 134 (3) ◽  
pp. 570-572 ◽  
Author(s):  
J. McVERNON ◽  
M. P. E. SLACK ◽  
M. E. RAMSAY
Keyword(s):  
Haemophilus Influenzae ◽  
Hospital Admissions ◽  
Upper Airway ◽  
Haemophilus Influenzae Type ◽  
Type B ◽  
Minimal Impact ◽  
Airway Infections ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Vaccine Availability

Paediatric cases of epiglottitis declined markedly in England following the introduction of safe effective immunization against Haemophilus influenzae type b (Hib). With the recently described resurgence in Hib infections, a corresponding rise in the number of presentations of clinical epiglottitis in children was observed, although numbers were still well below those reported prior to vaccine availability. This was seen both in microbiology reports and hospital admissions data for England. In keeping with the more diverse aetiology of epiglottitis in adults, Hib vaccination had minimal impact on hospital presentations with upper airway infections in those aged 15 years and over, which showed an overall increasing trend over 10 years. The need for a high index of suspicion to allow early diagnosis of this life-threatening clinical presentation is reinforced.

Haemophilus influenzae Type b Septic Arthritis in Children: Report of 23 Cases

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 254-259
Author(s):  
Harley A. Rotbart ◽  
Mary P. Glode
Keyword(s):  
Haemophilus Influenzae ◽  
Septic Arthritis ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Laboratory Findings ◽  
Viral Illness ◽  
History Of ◽  
Joint Examination ◽  
Wbc Count

Twenty-three cases of Haemophilus influenzae type b septic arthritis seen over a recent 5-year period are reviewed. The natural history of the disease includes a mean three days of fever and joint symptoms prior to hospitalization, often accompanied or immediately preceded by a viral illness and/or otitis media. Concurrent H influenzae type B meningitis was present in 30% of patients and concurrent osteomyelitis in 22%. Infants remained febrile in the hospital for a mean of 3.6 consecutive days. However, secondary and prolonged fevers were common. Clinical improvement in the joint examination was first seen at a mean of 2.5 days. Characteristic laboratory findings during recovery included a decline in total WBC count, neutrophil count, ESR, and hematocrit, with a concomitant increase in lymphocyte and platelet counts. Outpatient follow-up for a mean duration of 20 months found only two of 21 infants with residual impairment. The time to total healing in the remaining 19 infants, however, varied widely—from nine days to 17 months (mean of 4 months).

Patterns of Haemophilus influenzae type b Invasive Disease in New York State, 1987 to 1991: The Role of Vaccination Requirements for Day-Care Attendance

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1014-1016
Author(s):  
Elaine E. Schulte ◽  
Guthrie S. Birkhead ◽  
Stan F. Kondracki ◽  
Dale L. Morse
Keyword(s):  
New York ◽  
Haemophilus Influenzae ◽  
Day Care ◽  
New York State ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Day Care Centers ◽  
York State

Haemophilus influenzae type b (Hib) is the most common cause of bacterial meningitis in young children and is a major cause of other invasive bacterial disease.1 The case fatality rate for Hib meningitis is 1.0% to 3.4%.2,3 Also, 14% of meningitis cases result in persisting neurologic sequelae and 10% to 11% result in sensorineural hearing loss.4,5 With the introduction of Hib vaccines in 1985, what was once a potentially devastating disease is now preventable by vaccination.6 The risk of Hib in day-care centers (DCCs) is highest for younger children (≤23 months of age), during the first month of enrollment in day care, and for those children who attend larger day-care centers as opposed to home day-care settings.7 The incidence of Hib disease is higher for blacks, Hispanics, native Alaskans, American Indians, and children of lower socioeconomic status.8 Increasing enrollment in licensed DCCs throughout the country has provided an opportunity, through entrance requirements, to ensure that these children receive public health preventive measures such as vaccinations. Most states have laws requiring certain vaccinations before entry into DCCs; however, many states do not have a specific DCC entry requirement for Hib vaccination.9 The purposes of this article are to examine patterns of Hib incidence in New York State by gender, race, and age and to evaluate Hib disease within the DCC setting in New York State in relation to changing Hib vaccine requirements for DCCs. METHODS We conducted a retrospective study of invasive Hib disease in New York State outside New York City.

scholarly journals The Haemophilus influenzae Type b hcsA and hcsB Gene Products Facilitate Transport of Capsular Polysaccharide across the Outer Membrane and Are Essential for Virulence

2006 ◽  
Vol 188 (11) ◽  
pp. 3870-3877 ◽  
Author(s):  
Soila Sukupolvi-Petty ◽  
Susan Grass ◽  
Joseph W. StGeme
Keyword(s):  
Haemophilus Influenzae ◽  
Outer Membrane ◽  
Pathogenic Bacteria ◽  
Capsular Polysaccharide ◽  
Haemophilus Influenzae Type ◽  
Bacterial Disease ◽  
Gene Products ◽  
Type B ◽  
Critical Determinant ◽  
Underdeveloped Countries

ABSTRACT Haemophilus influenzae type b is a common cause of invasive bacterial disease, especially among children in underdeveloped countries. The type b polysaccharide capsule is a polymer of ribose and ribitol-5-phosphate and is a critical determinant of virulence. Expression of the type b capsule is dependent upon the cap b locus, which consists of three functionally distinct regions, designated regions 1 to 3. Region 3 contains the hcsA and hcsB genes, which share significant homology with genes that have been implicated in encapsulation in other pathogenic bacteria but have unclear functions. In this study, we inactivated hcsA alone, hcsB alone, and both hcsA and hcsB together and examined the effects of these mutations on polysaccharide transport and bacterial virulence properties. Inactivation of hcsA alone resulted in accumulation of polysaccharide in the periplasm and a partial decrease in surface-associated polysaccharide, whereas inactivation of hcsB alone or of both hcsA and hcsB together resulted in accumulation of polysaccharide in the periplasm and complete loss of surface-associated polysaccharide. All mutations eliminated serum resistance and abrogated bacteremia and mortality in neonatal rats. These results indicate that the hcsA and hcsB gene products have complementary functions involved in the transport of polysaccharide across the outer membrane and are essential for virulence.

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