[Haemophilus influenzae type B (Hib) meningitis in older children: about a case]. 2022

Ines Trabelsi, and Mouadh Ben Ali, and Manel Ben Romdhane, and Hanen Smaoui, and Imen Bel Hadj, and Khadija Boussetta
Service de Médecine Infantile B, Hôpital d'Enfants « Béchir Hamza » de Tunis, Tunis, Tunisie.

Since widespread vaccination, invasive Haemophilus influenzae type b (Hib) has become a rare infection. We here report the case of a 9-year-old boy admitted with seizures associated with fever and impaired general condition. First examination showed comatose child, Glasgow score 9/15, fever 38.2, deep tendon reflexes without frank meningeal syndrome. Laboratory tests showed polymorphonuclear neutrophils (PNN) with CRP 45.8. Cerebrospinal fluid (CSF) analysis revealed a cloudy appearance, pleiocytosis (6760 white blood cell count/ mm3) with neutrophil predominance (PNN = 90%, lymphocytes = 10%). Direct examination showed polymorphic bacilli, soluble antigen of Haemophilus influenzae type b, decreased glycorachy 0.04 mmol/L and hyper proteinorachie 4.097 g/L. MRI of the cerebellomedullary fissure revealed subtentorial and supratentorial encephalitis with bilateral parieto-occipital and cerebellar cortical and subcortical signal anomalies. The patient was treated with cefotaxime with favorable outcome. The patient had not been vaccinated against Hib in early childhood. After a 3-year follow-up, the patient was asymptomatic with no neurosensory sequelae. In subjects with severe Hib infection proof of vaccination or testing for underlying immunodeficiency are required.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008581 Meningitis Inflammation of the coverings of the brain and/or spinal cord, which consist of the PIA MATER; ARACHNOID; and DURA MATER. Infections (viral, bacterial, and fungal) are the most common causes of this condition, but subarachnoid hemorrhage (HEMORRHAGES, SUBARACHNOID), chemical irritation (chemical MENINGITIS), granulomatous conditions, neoplastic conditions (CARCINOMATOUS MENINGITIS), and other inflammatory conditions may produce this syndrome. (From Joynt, Clinical Neurology, 1994, Ch24, p6) Pachymeningitis,Meningitides,Pachymeningitides
D002439 Cefotaxime Semisynthetic broad-spectrum cephalosporin. Benaxima,Biosint,Cefotaxim,Cefotaxime Sodium,Cefradil,Cephotaxim,Claforan,Fotexina,HR-756,Kendrick,Klaforan,Primafen,Ru-24756,Taporin,HR 756,HR756,Ru 24756,Ru24756,Sodium, Cefotaxime
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006192 Haemophilus Infections Infections with bacteria of the genus HAEMOPHILUS. Hemophilus Infections,Haemophilus influenzae Infection,Haemophilus influenzae Type b Infection,Hib Infection,Infections, Haemophilus,Infections, Hemophilus,Haemophilus Infection,Haemophilus influenzae Infections,Hemophilus Infection,Hib Infections,Infection, Haemophilus,Infection, Haemophilus influenzae,Infection, Hemophilus,Infection, Hib
D006193 Haemophilus influenzae A species of HAEMOPHILUS found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through VIII. Bacterium influenzae,Coccobacillus pfeifferi,Haemophilus meningitidis,Hemophilus influenzae,Influenza-bacillus,Mycobacterium influenzae
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014611 Vaccination Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. Immunization, Active,Active Immunization,Active Immunizations,Immunizations, Active,Vaccinations
D019741 Haemophilus influenzae type b A type of H. influenzae isolated most frequently from biotype I. Prior to vaccine availability, it was a leading cause of childhood meningitis. Hemophilus influenzae type b,Hib

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