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Invasive Haemophilus influenzae type B disease
S L Tepper1, J Overman, J R Parker
1Office of the Chief Medical Examiner, Queens Hospital Center, Jamaica, NY.
Insights
Sudden infant death may be caused by invasive Haemophilus influenzae infections. Early diagnosis using latex agglutination is critical for public health and preventing spread, especially in day-care settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Forensic Pathology
Background:
- Invasive bacterial disease caused by Haemophilus influenzae is a significant cause of sudden, unexpected death in young children.
- Medical examiners should consider this pathogen in cases of fulminant, non-specific symptoms in children.
- The disease presents with severe symptoms, including meningitis, petechiae, purpura, and bilateral adrenal hemorrhage, leading to a rapidly fatal course.
Abstract:
Invasive bacterial disease due to Haemophilus influenzae is a cause of sudden death in children. It must be considered by medical examiners when a child dies with a fulminant course and nonspecific symptoms. Three fatal cases are presented in children 7 weeks to 15 months of age. Two had meningitis and petechiae or purpura. All three had bilateral adrenal hemorrhage and a rapidly fatal course. The potential for rapid and accurate diagnosis of H. influenzae infection is widely available due to latex agglutination technique against bacterial capsular wall antigens. Diagnosis is critical because of its public-health implications. Up to 50% of cases may be acquired in day-care settings. Chemoprophylaxis is recommended for household and day care contacts. With the recent introduction of Haemophilus b conjugate vaccines for routine administration to infants beginning at 2 months of age, a change in the epidemiology of the disease is anticipated.