Symptoms of Hemophilus Infection

Hemophilic infection has an incubation period, which is, apparently, two to four days. Hemophilus infection does not have a single classification. It is advisable to distinguish asymptomatic carriage, that is, when symptoms of hemophilic infection are absent, localized [ARI (rhinopharyngitis), ARI, complicated by sinusitis, otitis media; phlegmon, cellulitis) and generalized (invasive) forms of the disease (epiglottitis, pneumonia, septicemia, meningitis, osteomyelitis, arthritis).

ARDs that have been extruded by Haemophilus influenzae are not significantly different from those of other etiologies, but are often complicated by otitis and sinusitis.

Epiglottitis is an inflammation of the epiglottis, a severe form of Hib infection. Most often observed in children 2-7 years. The onset is acute: chills, high fever, drooling. Within a few hours, the symptoms of respiratory failure increase (inspiratory dyspnea, tachycardia, stridor, cyanosis, retraction of pliable areas of the chest). Patients are in a compelled position. Perhaps the development of septicemia, meningitis.

Phlegmon. Observe in children under 1 year, the most frequent localization - the head and neck. The clinical picture can resemble an erypsipelas. Possible bacteremia and meningitis.

Cellulite is also observed in children under 1 year old; more often localized on the face and neck. It often develops against the background of rhinopharyngitis. In the area of the cheek or around the orbit, on the neck appear hyperemia with a bluish tinge and puffiness of the skin. General intoxication is not expressed, but otitis media, meningitis and pneumonia can join.

Pneumonia. Symptoms of hemophilic infection do not differ from that of pneumococcal pneumonia. May be complicated by meningitis, pleurisy, septicemia.

Septicemia. Most often observed in children under 1 year. Characterized by hyperthermia, often hemorrhagic rash, the development of infectious-toxic shock.

Osteomyelitis, arthritis usually develop against the background of septicemia.

Meningitis caused by a haemophilic rod type b (Hib-meningitis) takes the third place in the frequency of occurrence in the aetiological structure of bacterial meningitis, ranging from 5 to 25%, and in children under 5 years of age - the 2nd place (10- 50%).

Having many similarities with other types of bacterial meningitis, Hib-meningitis is characterized by a number of significant clinical and pathogenetic features that must be taken into account in the early diagnosis and selection of the optimal tactics of etiotropic and pathogenetic therapy.

Hib-meningitis affects mainly children under the age of 5 years (85-90%). Often (10-30%) are sick and children under 1 year, including the first month of life. Children over 5 years and adults account for 5-10% of cases. In most patients, Hib-meningitis develops on a burdened premorbid background (organic CNS lesions, aggravated during the second half of pregnancy and childbirth, frequent respiratory infections in the anamnesis, disorders in the immune system). In children older than 5 years and adults, anatomical defects (spina bifida) are essential. These patients, as a rule, are repeatedly ill with bacterial meningitis of various etiologies.

The disease often begins subacute: with a cough, runny nose, fever to 38-39 ° C. Dyspeptic disorders may dominate in some patients in the initial period. This period lasts from several hours to 2-4 days, then the child's condition worsens: the symptoms of intoxication intensify, the temperature reaches 39-41 ° С, the headache increases, vomiting, meningeal symptoms of hemophilic infection, frustration of consciousness, convulsions, 2 days - focal symptoms. When the acute onset of the disease is catarrhal, the phenomena may be absent. The disease in these cases begins with a rapid increase in body temperature to 39-40 ° C, headache, vomiting. Clear meningeal syndromes appear on the 1-2-day sickness. On average, distinct signs of central nervous system damage in Hib meningitis are noted 2 days later than with meningococcal meningitis and a day later than with pneumococcal meningitis. This often leads to late diagnosis and late onset of etiotropic therapy.

Fever with Hib-meningitis is more often remitting or incorrect, it is recorded even against the background of antibacterial therapy, lasting from 3-5 to 20 (on average 10-14) day or more. The level of fever is higher than in bacterial meningitis of another etiology. Rashes are possible in some cases. Catarrhal phenomena in the form of pharyngitis are found in more than 80% of patients, rhinitis - in more than 50% of patients. Less frequent phenomena of bronchitis, in some patients - pneumonia. Often enlarged spleen and liver: no appetite, vomiting, regurgitation of food, stool retention (but diarrhea is possible). The inhibition of consciousness, adynamia, rapid exhaustion are characteristic for the majority of patients. Sopor develops less often, in some cases - a coma. Against the backdrop of dehydration and adequate antibacterial therapy, consciousness is fully restored in the period from 4-6 hours to 2-3 days. A marked picture of cerebral edema is observed in approximately 25% of patients, but signs of brain dislocation (coma, generalized convulsions, respiratory disorders) are much less common.

At the same time, focal neurological symptoms of hemophilic infection show no less than 50% of patients. More often, paresis of the cranial nerves, worsening of hearing, focal convulsions, ataxia, violations of muscle tone by extrapyramidal type, less often paresis of extremities.

Meningeal syndrome (in particular, bulging fontanel), the symptom of suspension is expressed moderately. Rigidity of the neck muscles is usually characteristic of children older than 1 year, and the symptoms of Brudzinsky and Kernig in some patients are mild or absent. The picture of cerebrospinal fluid is characterized by moderate neutrophilic or mixed pleocytosis, a slight increase in the level of protein. Turbidity of the cerebrospinal fluid can be caused by a huge amount of hemophilic rod, which, with microscopy, occupies the entire field of view. The glucose content in the first 1-2 days varies from a sharp decrease to a rise in level, after the third day - less than 1 mmol / l or glucose is not determined.

The picture of the blood differs little or moderately expressed leukocytosis: almost half of the patients have leukocytosis, the others have normocytosis or leukopenia. The majority of patients - absolute lymphopenia (up to 300-500 cells per 1 μl), as well as a tendency to reduce the number of red blood cells and hemoglobin.

[1], [2], [3], [4], [5]