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

P C Chan1, C Y Lu, P I Lee

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, ROC.

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|April 13, 2002
PubMed

Insights

Haemophilus influenzae type b meningitis in infants can present with subtle symptoms. Early recognition and management are crucial, though sequelae like hearing loss may persist.

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.

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