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Empyema due to beta-lactamase-producing H. influenzae type b complicating severe laryngo-pharyngitis and cervical
Abstract:
A 70-year-old woman presented to hospital with an acute life-threatening cervical cellulitis and laryngopharyngitis followed by pneumonia. Despite a month's treatment with intravenous antibiotics including cephamandole she developed a bacteremic empyema due to a beta-lactamase producing H. influenzae. Subsequent treatment with chloramphenicol and surgical drainage was curative. The same pathogen was later isolated from her grandson's throat. Chloramphenicol is recommended as the drug of choice in such cases.
Insights
A severe H. influenzae infection led to empyema despite initial antibiotic treatment. Chloramphenicol and surgery proved curative, highlighting its importance for beta-lactamase producing strains.
Area of Science:
- Infectious Diseases
- Microbiology
- Pulmonology
Background:
- A 70-year-old woman presented with acute cervical cellulitis, laryngopharyngitis, and subsequent pneumonia.
- Initial treatment with intravenous cephamandole was ineffective against the progressing infection.
Observation:
- The patient developed a bacteremic empyema caused by beta-lactamase producing Haemophilus influenzae.
- The same pathogen was later identified in her grandson's throat, suggesting potential transmission.
Findings:
- Intravenous antibiotics including cephamandole failed to resolve the H. influenzae infection.
- Treatment with chloramphenicol combined with surgical drainage resulted in a complete cure.
- Beta-lactamase production by H. influenzae was a key factor in treatment failure.
Implications:
- Chloramphenicol is recommended as the primary treatment for severe infections caused by beta-lactamase producing H. influenzae.
- This case underscores the importance of identifying beta-lactamase activity for appropriate antibiotic selection.
- Prompt surgical intervention may be necessary in conjunction with effective antibiotic therapy for empyema.