Hemophilia infection in children

Hemophilic infection is manifested by purulent meningitis, otitis media, various diseases of the respiratory tract (pneumonia, bronchitis, epiglottitis), conjunctivitis, endocarditis, osteomyelitis, etc.

ICD-10 code

A49.2 Infection caused by Haemophilus influenzae, unspecified.

Epidemiology

Although H. Influenzae is a conditionally pathogenic microorganism, in young children it can cause epidemic outbreaks. In these cases, diseases are caused by so-called epidemic clones of the pathogen with increased pathogenic and invasive properties. Outbreaks of infection in maternity hospitals, departments for patients with chronic diseases, among those treated with glucocorticoid and cytostatic drugs are described.

The source of infection are patients with obvious or erased forms of the disease, as well as healthy carriers. Transmission of the pathogen is most often carried out by airborne droplets. Transmission factors can also be infected linen, toys, household items. Children become infected by contact with parents, medical personnel, and also from each other.

The contagiosum index depends on the age. In children of the first year of life, it can reach 3-5%, at the age of up to 5 years - no more than 1-2%. Preterm infants with signs of primary or secondary immunodeficiency are most susceptible.

Classification of Haemophilus Infections

Depending on the localization of the process, pneumonia, meningitis, otitis media, osteomyelitis, acute epiglottitis, cellulitis are possible. In newborns, frequent clinical forms include septicemia, conjunctivitis, mastoiditis, purulent arthritis, and others.

Causes of Haemophilus Infection

H. Influenzae - gram-negative pleomorphic rod-shaped or coccoid cells measuring (0.2-0.3) x (0.5-2) μm. They are located in strokes singly or in pairs, and sometimes in the form of short chains and groups. On dense media, small (up to 1 mm in diameter) round, colorless colonies are formed. Microorganisms are immovable, they do not form a spore, but the formation of capsular forms with which they bind pathogenic properties is possible. The causative agent produces endotoxin, the carrier of which is considered capsular polysaccharides. Antigenic structure distinguishes 6 serotypes (a, b, c, d, e, f) - The leading value in the development of various pathological conditions is of type b. The microorganism is pathogenic only to humans,

Causes and pathogenesis of hemophilic infection

Symptoms of Hemophilus Infection

The pneumonia associated with H. Influenzae is approximately 5% of all patients with pneumonia; even more often this pathogen is sown from pleural exudate in patients with pleurisy. As a rule, the children of the first 2 years of life get ill.

The disease begins sharply with a rise in body temperature to 39-40 ° C, catarrhal phenomena and severe toxicosis. Symptomatology does not differ from other bacterial pneumonia. Percussion and auscultation detect a focus of inflammation in the projection of one or more segments of the lungs. The process is more often localized in the basal zones, but the lower and upper lobe of one or both lungs can be affected. Perhaps abscessed. X-ray changes are also not specific. In accordance with the clinical picture, foci of homogeneous darkening or dense focal-drainage shadows are identified in the event of exudative pleurisy.

Symptoms of Hemophilus Infection

Diagnosis of Haemophilus Infections

The results of a laboratory study are crucial for diagnosing hemophilic infection. Material from the patient (sputum, pus, aspirate from the lesion, spinal fluid, etc.) is microscopized (Gram staining) and inoculated on blood agar. The isolated pure culture is differentiated with a pertussis wand, with which H. Influenzae has a great similarity. Modern methods use PCR, latex-agglutination reaction, ELISA.

Differential diagnostics

Purulent meningitis caused by H. Influenzae is differentiated with meningococcal, streptococcal, pneumococcal, staphylococcal and other bacterial meningitis. The same can be said for other forms of infection: pneumonia, arthritis, pericarditis, etc. Although the diseases caused by H. Influenzae, there are no specific symptoms, yet such manifestations of the disease as panniculitis (cellulitis) and acute epiglottitis, are more likely to occur with infection caused by H. Influenzae. The crucial importance in differential diagnosis is the laboratory methods of investigation.

Treatment of Hemophilus Infections

Antibiotics are of paramount importance in the complex treatment of diseases caused by H. Influenzae. Preparations of choice - cephalosporins III and IV generations. The causative agent is also highly sensitive to levomycetin, gentamicin, rifampicin, but is resistant to oxacillin, lincomycin, etc. In severe cases it is recommended to prescribe two antibiotics.

Treatment and prevention of hemophilia infection

[1], [2], [3], [4], [5], [6], [7], [8], [9]