Neonatal sepsis due to nontypable Haemophilus influenzae

From August 1980 through July 1984, 19 neonates had sepsis due to Haemophilus influenzae. Onset of disease occurred within 48 hours after birth of all the neonates. One neonate was born at term and 18 were born prematurely, including seven neonates born before 28 weeks' gestation. Eight neonates and one fetus died, six of them within 24 hours of birth. Acute chorioamnionitis was present in the placentas. Those neonates with the most severe placental inflammation survived while all of those who died had moderate or only mild chorioamnionitis. Acute villitis was noted in the placentas of three neonates who died. Respiratory distress syndrome (in 15 neonates) and pneumonia (in 15 neonates) were noted in 18 liveborn patients. Nine mothers had fever, six of them with genitourinary infections and one with septicemia due to H influenzae. All isolates of H influenzae were submitted for serologic typing and none were typable. In 14 cases, isolates were biotyped yielding eight with biotype II, four with biotype III, and one each with biotypes IV and V. Neonatal sepsis due to nontypable H influenzae is now nearly as common as sepsis due to group B Streptococcus. Both organisms produce diseases with many features in common, especially fulminant courses with respiratory distress and pneumonia, and often have a fatal outcome.     

Urachal cyst infection caused by Haemophilus influenzae

The case of a 5 year-old boy with urachal cyst infection due to Haemophilus influenzae is reported. The difficulties encountered in isolating this bacteria when the correct procedures are not used can explain the apparent rarity of such infections. Physiopathological mechanisms of this infection are discussed with respect to the characteristics of the strain.     

Development of serum bactericidal activity following nontypable Haemophilus influenzae acute otitis media

We monitored the development of serum bactericidal antibody in eight children with acute nontypable Haemophilus influenzae otitis media and correlated its development with the appearance of antibody against lipooligosaccharide and surface-exposed outer membrane proteins of the infecting strains. Complement-dependent bactericidal activity was absent in acute sera but increased to titers of 1:4 to 1:32 in sera obtained 4 to 6 weeks later. Absorption of anti-lipooligosaccharide antibodies from convalescent sera had no effect on bactericidal titers of five patients and resulted in small decreases in titer in three patients. Lipooligosaccharide-absorbed samples had persisting bactericidal titers of 1:4 to 1:16. Four of eight acute samples lacked antibodies to surface-exposed outer membrane proteins whereas four had low concentrations of antibody directed against one or more Mr 100,000 to 250,000 outer membrane proteins. Convalescent samples from all eight children showed substantial increases in antibodies directed primarily against Mr 100,000 to 250,000 proteins. Thus, both surface-exposed Mr 100,000 to 250,000 outer membrane proteins and lipooligosaccharide are immunogenic during Haemophilus otitis media and are potential targets of bactericidal antibody.     

Haemophilus influenzae type b pneumonia.

Thirteen patients with Haemophilus influenzae type b pneumonia are reported to emphasise the clinical, radiographic, and therapeutic aspects of this illness. All but one patient was under 2 1/2 years of age. The presenting complaint was a variable duration of upper respiratory infection and fever in most cases. One-third of patients had radiographic evidence of pleural involvement; one-third showed a patchy bronchopneumonia on roentgenogram; and the remainder had segmental or lobar infiltrates. Clinical response to antibiotic therapy was prompt in patients without pleural involvement.     

Haemophilus influenzae Type f sepsis in an immunocompetent child

Invasive infections due to Haemophilus influenzae non-type b have been reported to be on the increase with the decline in invasive H.influenzae type b infections after the introduction of the conjugate H.influenzae type b vaccine. We report a case of H. influenzae type f sepsis in a fully immunized, immunocompetent, and previously healthy 9-month-old child.