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Pneumonia caused by a hemophilic rod: causes, symptoms, diagnosis, treatment

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Haemophilus Influenzae (haemophilus bacterium Afanasyev-Pfeifer) is a frequent causative agent of out-of-hospital pneumonia. Hemophilus influenza often lives on the mucous membrane of the upper respiratory tract, it can penetrate into the lower parts of the respiratory tract and cause an exacerbation of chronic bronchitis. Virulent strains have a capsule; Antigenic structure distinguishes 6 serotypes of H. Influenzae: a, b, c, d, e, f. Strains containing the antigen b (Hib) are the most virulent and most often cause severe pneumonia, as well as severe damage to the nervous system - meningoencephalitis. Capsular antigen, determining the specificity of H. Influenzae type b, is polyribophosphate.

There are risk groups for pneumonia caused by a hemophilic rod:

representatives of low socio-economic strata in poor hygienic and economic conditions;
representatives of the black race;
patients with a distant spleen;
patients with lymphoproliferative diseases, primarily lymphogranulomatosis;
patients with impaired antibody education function;
Children up to 6 years of age, visiting nurseries and kindergartens.

Clinical features of pneumonia caused by a hemophilic rod

More often than not, pneumonia caused by a hemophilic rod develops in one-year-old children and proceeds quite hard, and half of patients develop exudative pleurisy early.

In adult patients, the hemophilic rod mainly causes focal pneumonia, which is manifested by fever, coughing with mucopurulent sputum, blunting of percussion sound over the lesion, crepitation and small bubbling rales. However, pneumonia can be complicated by pleurisy (fibrinous or exudative), pericarditis, arthritis, meningitis and even sepsis.

Diagnostic criteria for pneumonia caused by a hemophilic rod

Pneumonia caused by a hemophilic rod is diagnosed on the basis of the following provisions:

analysis of the corresponding, described above clinical picture;
detection in smears of sputum with a Gram stain of many small gram-negative rods;
positive results of sputum culture, pleural fluid on special media - blood or chocolate agar (the blood of a rabbit or a horse is added to agar). In the presence of 5% CO, at a temperature of 37 ° C, the colonies of the hemophilic rod develop after 24 hours;
detection of the capsular antigen of the hemophilic rod (polyribophosphate) in the blood and urine of the patient. For this, the methods of latex and coagglutination, immunoelectrophoresis, inhibition of indirect haemagglutination inhibition, and also a test system with monoclonal antibodies to capsul antigen are used.

Treatment of pneumonia caused by a hemophilic rod

The first line of antibiotic is ampicillin (amoxicillin) to 2-4 g per day. In the case of resistance strains, a combination of amoxicillin and clavulanate (augmentin) is used. Effective also cephalosporins of the second and third generations, aztreonam, quinolones.

trusted-source [1], [2], [3], [4]