[Phlegmona ("cellulitis") and Haemophilus influenzae meningitis]

Area of Science:

• Pediatric Infectious Diseases
• Bacteriology
• Clinical Medicine

Background:

• Soft tissue inflammation, known as cellulitis in Anglo-American literature, is a rare manifestation of Haemophilus influenzae (H. influenzae) infection.
• Concomitant bacteremia or septicemia often accompanies H. influenzae cellulitis.
• The simultaneous occurrence of cellulitis and meningitis due to H. influenzae is infrequently documented in German pediatric literature.

Observation:

• This report describes three pediatric cases presenting with facial cellulitis and H. influenzae meningitis.
• Unusual observations included early cellulitis onset at six weeks in two infants.
• One case featured cellulitis of the lower extremities concurrently with meningitis, and another showed a biphasic course involving meningitis secondary to mastoiditis.

Findings:

• H. influenzae can present with a rare combination of cellulitis and meningitis in children.
• The study highlights variations from typical presentations, including early-onset and lower extremity cellulitis.
• A biphasic disease course, with meningitis developing after mastoiditis, was observed in one patient.

Implications:

• This case series expands the understanding of H. influenzae's clinical spectrum in pediatric patients.
• It emphasizes the need for awareness of unusual presentations of H. influenzae infections, particularly the cellulitis-meningitis combination.
• The findings may inform diagnostic and treatment strategies for H. influenzae-related soft tissue infections and meningitis in infants and children.