Haemophilus influenzae type b meningitis in a vaccinated and immunocompetent child

Abstract

Invasive Haemophilus influenzae type b (Hib) disease decreased dramatically after the introduction of conjugate vaccine in routine immunization schedules. We report a case of a fifteen-months-old girl, previously healthy and vaccinated, admitted in the emergency room with fever and vomiting. She was irritable and the Brudzinski's sign was positive. The cerebrospinal fluid (CSF) analysis showed pleocytosis and high protein level. Empiric intravenous antibiotics (ceftriaxone and vancomycin) were administered for suspected bacterial meningitis during 10 days. Serotyping of the Haemophilus influenzae strain found in CSF revealed a serotype b. After one year of follow-up no Hib meningitis sequelae were noted. Despite vaccination compliance and absence of risk factors, invasive Hib disease can occur due to vaccine failure. Efforts to keep the low incidence of invasive Hib disease should be directed to the maintenance of high vaccination coverage rates, combined with the notification and surveillance strategies already implemented in each country.

Immune responses to vaccine-preventable diseases among toddlers and preschool children after primary immunization and first booster in Northwestern Algiers, Algeria

“…Only one toddler 19 months old had concentration of anti-PRP antibodies <0.15 μg/ml, despite of being fully vaccinated with 4 doses. As demonstrated in previous studies, this may represent vaccine failure, breach in the cold chain during transportation and storage or delay in immune response [ 34 , 35 , 36 , 37 ].…”

Vaccine-Preventable Diseases Requiring Hospitalization

“…Although cases have been reported in vaccinated, immunocompetent children, this is extremely rare and none occurred at our center during the 10 years evaluated. 14,15 Previous research suggests that central-Pennsylvania Plain communities may act as a reservoir for a Hib outbreak if vaccination rates in the general population decline to less than critical levels. 7 We found that Hib infections occurred sporadically throughout the study period with no major outbreaks, suggesting that current population seroprotection may be sufficient to prevent an Hib epidemic.…”

Hemophilus Septicemia Meningitis in an 11-Month-Old Vaccinated Infant

“…Haemophilus influenzae (H. influenzae) is a gram-negative coccobacillus and a common cause of various invasive and non-invasive bacterial infections that include meningitis, pneumonia, and otitis media. H. influenzae is divided into two main types, namely, encapsulated and non-encapsulated, which are further divided, according to the composition of the capsule polysaccharide, into six different serotypes, namely, a, b, c, d, e, and f [1,2]. H. influenzae type b (Hib) is the most common and virulent serotype as it accounts for most cases of H. influenzae invasive disease in children [3].…”