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A case of Haemophilus parainfluenzae pneumonia
A Pillai1, J L Mitchell, S L Hill
1Department of Respiratory Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK.
Abstract:
A 41 year old woman presented with community acquired pneumonia (CAP) which failed to resolve following treatment with amoxycillin and cefaclor prior to referral. Quantitative culture of sputum revealed a pure growth of Haemophilus parainfluenzae and, following antibiotic susceptibility testing of the isolate, ciprofloxacin was prescribed resulting in resolution of the infection. Immunological investigations showed that the patient had a high titre of H parainfluenzae specific IgM. The combination of a pure growth of H parainfluenzae, a response to appropriate antimicrobial therapy, and the presence of a specific antibody response indicated that this organism had a pathogenic role in the patient's pneumonia and should be considered in the differential diagnosis of CAP.
Insights
Haemophilus parainfluenzae can cause community-acquired pneumonia (CAP) in adults. Prompt diagnosis and targeted antibiotic therapy, like ciprofloxacin, are crucial for effective treatment and resolution of infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Community-acquired pneumonia (CAP) is a common infection, often treated empirically.
- Recalcitrant CAP cases require thorough etiological investigation.
- Haemophilus parainfluenzae is a commensal bacterium, rarely implicated as a primary pathogen in pneumonia.
Observation:
- A 41-year-old woman presented with persistent CAP despite initial antibiotic treatment.
- Sputum culture revealed a pure growth of Haemophilus parainfluenzae.
- Immunological studies detected a high titer of H. parainfluenzae-specific IgM antibodies.
Findings:
- Antibiotic susceptibility testing guided the selection of ciprofloxacin.
- Ciprofloxacin therapy resulted in the complete resolution of the pneumonia.
- The presence of pure H. parainfluenzae growth, specific IgM response, and treatment efficacy confirmed its pathogenic role.
Implications:
- Haemophilus parainfluenzae should be considered in the differential diagnosis of refractory CAP.
- Accurate microbiological identification and susceptibility testing are vital for optimizing CAP treatment.
- This case highlights the potential pathogenicity of H. parainfluenzae in specific clinical contexts.