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Hemophilus influenzae type B cellulitis in adults.
The American Journal of Medicine
|October 1, 1986
Summary
Haemophilus influenzae type B cellulitis is rare in adults but treatable. This case highlights a clinical syndrome in older adults, emphasizing prompt diagnosis and specific antibiotic treatment for H. influenzae type B infections.
Area of Science:
- Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Haemophilus influenzae type B (Hib) is a significant cause of invasive disease, primarily in unvaccinated children.
- While Hib infections are less common in adults, they can present with severe manifestations.
Observation:
- A 67-year-old woman presented with anterior neck cellulitis.
- The condition was confirmed by positive blood cultures identifying Hib.
- A review of literature identified six similar adult cases.
Findings:
- A distinct clinical syndrome of Hib anterior neck cellulitis in adults over 50 years old was observed.
- This syndrome includes initial pharyngitis, followed by high fever, rapid anterior neck swelling, tenderness, erythema, and dysphagia.
- The causative organism, Hib, may exhibit ampicillin resistance.
Implications:
- Early diagnosis and appropriate antibiotic selection are crucial for treating adult Hib cellulitis.
- Chloramphenicol is recommended due to potential ampicillin resistance.
- Combination therapy with a beta-lactamase-resistant penicillin or cephalosporin, or a third-generation cephalosporin, is advised to cover potential co-pathogens and ensure broad-spectrum coverage.