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Bacteraemic Haemophilus influenzae pneumonia
1Dept. of Respiratory Physiology, City General Hospital, Stoke on Trent, Staffs, UK.
Abstract:
Bacteraemia with Haemophilus pneumonia is uncommon. To determine its incidence and features case notes of patients in whom Haemophilus spp. were isolated from blood and pleural fluid over a five-year period were reviewed. Eight adult patients with H. influenzae bacteraemia were identified, five of whom had pneumonia on clinical and radiographic criteria. Only one patient had a predisposing factor, chronic obstructive lung disease. Two patients had beta-lactamase producing isolates, one of whom developed an empyema, following treatment with ampicillin, which required surgical drainage. Four patients were elderly, aged 69-80 yrs and were clinically in shock at the time of diagnosis. Seven of the eight patients survived.
Insights
Haemophilus influenzae pneumonia bacteraemia is rare but serious, particularly in the elderly. Early diagnosis and treatment are crucial, as some strains produce beta-lactamase, complicating management and potentially leading to empyema.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonary Medicine
Background:
- Bacteraemia caused by Haemophilus species, particularly Haemophilus influenzae, is infrequently documented.
- Pneumonia is a common manifestation of respiratory infections, but bacteraemia complicates its presentation.
Purpose of the Study:
- To determine the incidence and clinical features of Haemophilus species bacteraemia, specifically in patients with pneumonia.
- To identify risk factors and outcomes associated with Haemophilus influenzae bacteraemia.
Main Methods:
- A retrospective review of case notes was conducted over a five-year period.
- Patients with Haemophilus spp. isolated from blood and pleural fluid were identified and analyzed.
Main Results:
- Eight adult patients with Haemophilus influenzae bacteraemia were identified; five had concurrent pneumonia.
- One patient had chronic obstructive lung disease as a predisposing factor.
- Two isolates were beta-lactamase producing, with one case progressing to empyema requiring surgical drainage.
- Four elderly patients (69-80 years) presented in shock.
- Seven out of eight patients survived.
Conclusions:
- Haemophilus influenzae bacteraemia, though uncommon, can present as severe pneumonia, especially in the elderly.
- The emergence of beta-lactamase producing strains necessitates careful antibiotic selection to prevent complications like empyema.
- Prompt diagnosis and management are vital for favorable outcomes in these patients.