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Hemophilus influenzae type b meningitis: pediatric overview
S Catania1, M P Ronchetti, N Catania
1Department of Infectious and Tropical Diseases, La Sapienza, University of Rome.
Insights
Haemophilus influenzae type b (Hib) meningitis is a serious childhood illness, accounting for over 22% of bacterial meningitis cases. Early diagnosis and treatment are crucial, and vaccination is recommended.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis poses a significant threat to child health.
- Haemophilus influenzae type b (Hib) is a primary causative agent of meningitis in children.
- Understanding the incidence and clinical features of Hib meningitis is vital for effective management.
Purpose of the Study:
- To determine the incidence and clinical therapeutic aspects of Haemophilus influenzae type b (Hib) meningitis in children.
- To analyze the clinical presentation, diagnosis, treatment, and outcomes of Hib meningitis.
- To evaluate the need for Hib conjugate vaccination in Italy.
Main Methods:
- Retrospective study of children diagnosed with acute purulent meningitis between January 1982 and December 1994.
- Analysis of 89 cases, with specific focus on 20 cases of Hib meningitis.
- Cerebrospinal fluid (CSF) culture, latex agglutination tests for bacterial antigens, and urine antigen detection were employed.
Main Results:
- Hib meningitis accounted for 22.47% of all bacterial meningitis cases (20/89).
- Among children under 5 years, Hib was the most frequent pathogen (34.47%, 20/58).
- Complications occurred in 20% of cases, and sequelae in 10%; no deaths were reported.
Conclusions:
- Hib meningitis is a severe condition in children, particularly those under 5 years.
- Prompt diagnosis and appropriate antibiotic therapy are essential.
- The study supports the justification for widespread administration of conjugate vaccines against Hib in Italy.
Abstract:
The authors valued the incidence and clinical therapeutic aspects of Haemophilus influenzae type b (Hib) meningitis in children. They report a retrospective study, in children, with diagnosis of acute purulent meningitis, from January 1982 to December 1994, aged between 1 month and 14 years. Particular attention was direct to Haemophilus influenzae type b meningitis (20 cases). The incidence rate of Hib meningitis in the overall cases (89) was 22.47% (20), while among children younger than 5 years Hib was the most frequently pathogen isolated (20/58-34.47%). In 1/4 of cases, particularly in children younger than 1 years, exordium was aspecific and unclear. At admission culture and examination of Cerebrospinal Fluid (CFS) have been done. CFS was cultured on blood agar and chocolate plates. A latex agglutination test was used for rapid detection of the bacterial antigens. In some cases we looked for bacterial antigens in urine. 20% of children had complications and 10% had sequelae (1 years of follow-up). We didn't have any dead. Antibiotic treatment was principally with Ampicillin, Cephalosporin and Chloramphenicol. The results of this study confirm the Hib gravity and suggest that the administration of conjugate vaccine against Hib to all living in Italy is justified.