Haemophilus influenzae type b bacteremia in older children

Haemophilus influenzae type b (HIB) is a well-recognized cause of serious infection in infants and toddlers. However, little information exists regarding HIB infections in older children. This report describes serious HIB infections in 23 children (eight immunocompromised; 15 immunocompetent) older than 59 months of age. Data were collected over an 11-year period. The mean age of the children was 7.6 years (range, 5-15 years), and 14 were male. While three of the eight immunocompromised children had HIB pneumonia, none of the immunocompetent group had this diagnosis. Eleven of the 15 immunocompetent children had epiglottitis or meningitis. HIB bacteremia without focal infection occurred in four children, two immunocompromised and two immunocompetent. This study supports the recommendation of empiric HIB antibiotic therapy for children up to 12 years of age who have serious infections. Antibiotics effective against HIB should be included in the presumptive antibiotic therapy of seriously ill immunocompromised children, regardless of age.