Abstract • During a four-year surveillance period in a tertiary care children’s hospital, nine children experienced 11 episodes of Haemophilus influenzae non–type b invasive infections, representing 9% of all invasive H influenzae infections. Of these nine children, two had lymphoproliferative disorders; one had immunoglobulin subclass deficiency; one had severe congenital heart disease, with chronic heart failure; two had cerebrospinal fluid leaks; and two were premature neonates whose mothers had prolonged rupture of amniotic membranes. Only one child had no evidence of an underlying condition that might predispose him to infection with these ordinarily nonpathogenic organisms. Three of the isolates were serotype f, one was serotype e, and the remaining seven were nontypable, with types a through f antisera. Thus, the majority of children experiencing invasive H influenzae non–type b infections appear to have a predisposing medical condition. To aid in detecting these unusual infections, all H influenzae isolates from otherwise sterile body sites should be serotyped, and those children with non–type b isolates should be evaluated for a possible predisposing underlying illness. Back to top Article Information Accepted for publication May 16, 1987. Reprint requests to F7828/0244, C. S. Mott Children's Hospital, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0244 (Dr Gilsdorf). I would like to acknowledge the contributions of Roger Faix, MD, in providing the data on neonatal infections and Jerri Jenista, MD, and Thomas Shope, MD, for their helpful suggestions. References 1. Turk DC, May JR. Haemophilus influenzae: Its Clinical Importance. London, English Universities Press Ltd, 1967, pp 13-23. 2. Lerman SJ, Kucera JC, Brunken JM. Nasopharyngeal carriage of antibiotic-resistant Haemophilus influenzae in healthy children. Pediatrics. 1979;64:287-290. PubMedGoogle Scholar 3. Greene GR. Meningitis due to Haemophilus influenzae other than type b: Case report and review. Pediatrics. 1978;62:1021-1025. PubMedGoogle Scholar 4. Reddy CM. Haemophilus influenzae type d pneumonia. AJDC. 1979;133:96. PubMedGoogle Scholar 5. Losonsky GA, Santosham M, Sehgal FM, et al. Haemophilus influenzae disease in the White Mountain Apaches: Molecular epidemiology of a high-risk population. Pediatr Infect Dis. 1984;3:539-547. PubMedGoogle ScholarCrossref 6. Shann F, Gratten M, Germer S, et al. Aetiology of Pneumonia in children in Goroka Hospital, Papua, New Guinea. Lancet. 1984;2:537-541. PubMedGoogle ScholarCrossref 7. Gratten M, Barker J, Shann F, et al. Non–type b Haemophilus influenzae meningitis. Lancet. 1985;1:1343-1344. PubMedGoogle ScholarCrossref 8. Wall RA, Mabey DCW, Corrah PT. Haemophilus influenzae non-type b. Lancet. 1985;2:845. PubMedGoogle ScholarCrossref 9. Rutherford GW, Wilfort CM. Invasive Haemophilus influenzae type a infections: A report of two cases and a review of the literature. Pediatr Infect Dis. 1984;3:575-577. PubMedGoogle ScholarCrossref 10. Mason EO, Kaplan SL, Lamberth LB, et al. Serotype and ampicillin susceptability of Haemophilus influenzae causing systemic infections in children: Three years of experience. J Clin Microbiol. 1982;15:543-546.Google Scholar 11. Tedd JK, Bruhn FW. SevereHaemophilus influenzae infections. AJDC. 1975;129:607-611. PubMedGoogle Scholar 12. Bartlett AV, Zesman J, Daum RS. Unusual presentations of Haemophilus influenzae infections in immunocompromised patients. J Pediatr. 1983;102:55-58. PubMedGoogle ScholarCrossref 13. Siber G. Bacteremias due to Haemophilus influenzae and Streptococcus pneumoniae: Their occurrence and course in children with cancer. AJDC. 1980;134:668-672. PubMedGoogle Scholar 14. Wallace RJ, Baker CJ, Quinones FJ, et al. Nontypable Haemophilus influenzae (biotype 4) as a neonatal, maternal, and genital pathogen. Rev Infect Dis. 1983;5:123-136. PubMedGoogle ScholarCrossref 15. Ward JI, Siber GR, Scheifele DW. Rapid diagnosis of Haemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis. J Pediatr. 1978;93:37-42. PubMedGoogle ScholarCrossref 16. Slade HB, Schwartz SA. Selective antibody deficiency and recurrent pneumococcal bacteremia in a patient with Sjögren's syndrome, hyperimmunoglobulinemia G, and deficiencies of IgG2 and IgG4. N Engl J Med. 1985;313-891. PubMedGoogle Scholar 17. Campognone P, Singer DB. Neonatal sepsis due to Haemophilus influenzae. AJDC. 1986;140:117-121. PubMedGoogle Scholar 18. Granoff DM, Basden M. Haemophilus influenzae infections in Fresno County, California: A prospective study of the effects of age, race, and contact with a case on incidence of disease. J Infect Dis. 1980;141:40-46. PubMedGoogle ScholarCrossref
American Journal of Diseases of Children – American Medical Association
Published: Oct 1, 1987
Keywords: haemophilus influenzae,child,infections,cerebrospinal fluid leak,immunoglobulin subclass,immune sera,lymphoproliferative disorders,rupture,chronic heart failure,congenital heart disease,amnion,infant, premature
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