Clinical and laboratory characteristics of haemophilus influenza type b Infection with central nervous system Involvement in young children

Introduction. Invasive Haemophilus influenza type b (Hib) infection often manifests as severe and complicated forms of purulent meningitis in children from birth to 6 years of age. Hib meningitis is the most commonly diagnosed invasive form, with a severe course. There is no generally accepted clinical classification of Hib infection. Along with meningitis, the infection is often manifested with purulent inflammatory foci of different localization.

The objective was to characterize the course of purulent Hib meningitis, including in combination with purulent foci, in young children.

Methods and materials. We analyzed 45 case histories of children (under the age of 3 years) who had an invasive Haemophilus infection with purulent meningitis. Hib meningitis (Group-1) was diagnosed in 17 patients and meningitis in combination with specific purulent foci was diagnosed in 28 patients (Group-2). The diagnosis in all patients was confirmed bacteriologically or serologically (Latex Agglutination Test).

Results. The combination of meningitis with purulent foci of Hib infection was characterized by late hospitalization (36 %), longer recovery of cerebrospinal fluid, longer duration of the disease, and the prevalence of severe and complicated disease, and often required surgical treatment (46.4 %). A burdened premorbid background is traditionally considered a condition for the development of invasive Hib infection. According to our data, only 40 % of children had a burdened premorbid background, which is confirmed by clinical cases.

Conclusion. Since Hib infection in young children is often combined with meningitis with purulent foci, is characterized by a severe and complicated course, and often requires surgical treatment, it is advisable to consider this form of infection separately. 

1. Vengerov Yu. Ya. Gemofil’naya infektsiya // Infektsionnye bolezni: Natsional’noe rukovodstvo / eds by N. D. Yushchuk, Yu.Ya. Vengerov. Moscow, GEOTAR-Media, 2019: 346–353. (In Russ.). Doi: 10.33029/9704-6122-8-INB-2021-1-1104.

2. Frolova E. Ya., Filatov V. N. Epidemiological Monitoring and Prevention of Haemophilus influenzae type b in the RF // Journal Infectology. 2012;4(2):73–83. (In Russ.). Doi: 10.22625/2072-6732-2012-4-2-73-83.

3. Vengerov Yu. Ya., Nagibina M. V., Bogatyreva E. P., Bykova R. N., Koroleva I. S., Kryuchkova T. V., PIatonov A. E., MigmanovT.E., SvistunovaT. S.The clinical picture, diagnosing and treatment of Hib-meningitisin children //Infect. bolezni [Infectious diseases]. 2007;5(4):32–36. (In Russ.).

4. VilnitsA.A., Skripchenko N. V., Ivanova M. V., Ivashchenko I.A., Mazaeva E. M. Current features of Haemophilus meningitisin children. Èpidemiologiâ i infekcionnye bolezni. Aktual’nye voprosy [Epidemiology and Infectious Diseases. Current Items]. 2016;(5):50–54. (In Russ.).

5. Egorova T. V., Malkova L. V., Dziuban I. F., Stolbov A. L. Hemophilic meningitis in children // Children infections. 2013;12(1):53–57. (In Russ.). Doi: 10.22627/2072-8107-2013-12-1-53-57.

6. Vilnits A. A., Skripchenko N. V., Gorelik E. Yu., Astapova A. V., Markova K. V., Egorova E. S. Bacterial purulent meningitis in children: is there a light at the end of the tunnel? // Children infections. 2021;20(4):28–34. (In Russ.). Doi: 10.22627/2072-8107-2021-20-4-28-34.

7. Koroleva I. S., Koroleva M. A., Melnikova A. A. Epidemiology of purulent bacterial meningitis in the period of pneumococcal and haemophilus vaccination in the Russian Federation // Èpidemiologiâ i infekcionnye bolezni. Aktual’nye voprosy [Epidemiology and Infectious Diseases. Current Items]. 2017;6:63–68. (In Russ.).

8. Vengerov Yu. Ya., Nagibina M. V., Kovalenko T. M., Matosova S. V., Rusin P. V., Smirnova T. Yu., Mikhalynova E. P., Razdobarina S. E. Current aspects of pathogenesis, diagnosis and treatment of purulent bacterial meningitis. // Infectious Diseases: News, Opinions,Training. 2018;7(1):78– 85. (In Russ.). Doi: 10.24411/2305-3496-2018-00010