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Assessing Respiratory Immune Responses to Haemophilus Influenzae
Published on: June 29, 2021
Invasive Haemophilus influenzae Serotype f Case Reports in Mazovia Province, Poland
Anna Golebiewska1, Alicja Kuch, Agnieszka Gawrońska
1From the Paediatric Ward, Wołomin County Hospital (AG, EK); Department of Epidemiology and Clinical Microbiology, National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw (AK, AS); Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw (AG, PA, AR); and Department of Paediatric Respiratory Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland (WF).
Abstract:
After successful introduction of anti-Haemophilus influenzae (Hi) serotype b vaccination program in Poland, invasive non-b or nontypeable H. influenzae infections have been reported more frequently alike in other countries all over the world. In this paper, we report 2 cases of H. influenzae serotype f (Hif) meningitis with severe clinical presentations which are rarely seen in previously healthy children.The first case is a 6-year-old girl who was admitted to pediatric ward with signs of meningitis. Laboratory tests confirmed bacteremic meningitis caused by Hif. The girl responded very well to administered treatment and recovered without any further complications. No underlying comorbidities were found. The second patient was a 4-year-old boy who, in course of Hif bacteremic meningitis, developed rapid septicemia and, despite aggressive treatment, died within a few hours of hospitalization. The child's past history was unremarkable.By presenting these cases, we would like to remind clinicians that invasive non-b Hi infections can become fatal not only in the group of the youngest children or children with coexisting comorbidities, as most commonly reported in the worldwide literature. At the same time, we want to emphasize the legitimacy of constant monitoring Hi epidemiology in order to take accurate actions if necessary.
Insights
Invasive Haemophilus influenzae (Hi) serotype f meningitis can be severe and fatal in healthy children. Continued monitoring of Hi epidemiology is crucial for public health.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- The widespread Haemophilus influenzae (Hi) serotype b vaccination program has led to an increased incidence of invasive non-b and nontypeable Hi infections globally.
- Non-b serotypes, particularly serotype f (Hif), are emerging as significant pathogens, necessitating a re-evaluation of their clinical impact.
Observation:
- Two cases of severe Hif meningitis in previously healthy children are presented.
- A 6-year-old girl experienced bacteremic meningitis with a favorable outcome after treatment.
- A 4-year-old boy rapidly developed fatal septicemia secondary to Hif meningitis despite aggressive medical intervention.
Findings:
- Invasive Hif infections can present with severe clinical manifestations, including fatal outcomes, even in immunocompetent children without comorbidities.
- These cases highlight that severe invasive non-b Hi disease is not limited to the very young or immunocompromised populations.
Implications:
- Clinicians should maintain a high index of suspicion for invasive non-b Hi infections, including Hif, in all pediatric age groups.
- The findings underscore the importance of ongoing surveillance of Hi epidemiology to guide public health strategies and clinical management.
- These rare but severe presentations emphasize the need for continued research into the pathogenesis and treatment of non-b Hi infections.
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