Haemophilus influenzae type b meningitis with subdural effusion: a case report

Area of Science:

• Pediatrics
• Infectious Diseases
• Neurology

Background:

• Haemophilus influenzae type b (Hib) causes invasive infections in young children, potentially leading to severe neurologic sequelae.
• Routine Hib vaccination has significantly reduced invasive Hib disease incidence globally.
• Low incidence in Taiwan means clinicians may lack familiarity with Hib meningitis presentation and management.

Observation:

• A 7-month-old infant presented with prolonged fever and vague neurologic signs, diagnosed with Hib meningitis.
• Facial palsy, hearing loss, and subdural effusion developed during initial cefotaxime treatment.
• Betamethasone and prednisolone were used to manage inflammation and drug-induced fever.

Findings:

• The patient experienced persistent left ear hearing impairment post-treatment.
• No significant developmental delay was noted during follow-up.
• Hib meningitis management in low-incidence settings requires careful monitoring for complications.

Implications:

• This case highlights the importance of considering Hib meningitis in infants with non-specific symptoms, even in low-incidence areas.
• Awareness of potential complications like hearing loss and facial palsy is vital for clinicians.
• Prompt and appropriate management, including adjunctive therapies, can mitigate severe outcomes, but long-term sequelae may occur.