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Hemophilus influenzae meningitis and septicaemia in a 14-month-old child after primary immunisation

B Tarai1, N Ravishankar, P Vohra

  • 1Department of Microbiology, Max Super Speciality Hospital, Saket, New Delhi, India.

Indian Journal of Medical Microbiology
|January 7, 2015
PubMed

Insights

A 14-month-old child developed Haemophilus influenzae meningitis despite receiving three vaccine doses. This case highlights potential vaccine failure after primary immunisation alone.

Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Microbiology

Background:

  • Haemophilus influenzae type b (Hib) meningitis is a serious bacterial infection primarily affecting young children.
  • Vaccination has significantly reduced the incidence of Hib meningitis globally.
  • Primary immunisation series typically involves multiple doses to elicit a protective immune response.

Observation:

  • A 14-month-old male infant presented with fever and seizures.
  • Cerebrospinal fluid (CSF) and blood cultures confirmed Haemophilus influenzae meningitis and concurrent septicemia.
  • Elevated procalcitonin (104 ng/ml) and C-reactive protein (CRP, 42.6 mg/dl) indicated a significant systemic inflammatory response.

Findings:

  • The infant had received three primary doses of the Haemophilus influenzae vaccine prior to disease onset.
  • Despite vaccination, the child developed invasive Hib disease, suggesting a potential vaccine failure.
  • Prompt administration of appropriate antibiotics led to an uneventful recovery.

Implications:

  • This case underscores the possibility of vaccine failure, even after completing the primary immunisation schedule.
  • It emphasizes the importance of continued surveillance for invasive bacterial infections in vaccinated populations.
  • Further research may be needed to understand factors contributing to primary vaccine failure in Hib meningitis.

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