Meningitis Due to Haemophilus influenzae Type f in an 8-Year-Old Girl with Congenital Humoral Immunodeficiency

Abstract

We report on an 8-year-old Haemophilus influenzae type b-vaccinated girl with meningitis due to H. influenzae type f. The girl had an oro-facio-digital syndrome and a hypogammaglobulinemia, obviously predisposing the patient to invasive infections. Treatment with cefotaxime was successful.Incidence, predisposing factors and the influence of H. influenzae type b immunization on invasive infections with non-type b H. influenzae strains in children are discussed.

Invasive Infections with Haemophilus influenzae Serotype a Containing an IS1016-bexA Partial Deletion: Possible Association with Virulence

“…As has been documented by others, immunodeficiencies may play a significant role in the pathogenesis of invasive disease due to Hia, as well as other non-b capsular serotypes, in adult and pediatric populations [1,24,25]. Additionally, the pediatric age group historically at highest risk for invasive H. influenzae disease is one in which there is welldocumented immaturity of the B cell immune response to polysaccharide antigens [1].…”

Epidemiologic and Microbiologic Characteristics of Recurrent Bacterial and Fungal Meningitis in The Netherlands, 1988–2005

“…In contrast, the proportion of cases due to the rare serogroups W135, Y, and Z among 99 episodes of recurrent meningococcal disease was higher than that among the episodes of nonrecurrent meningococcal disease, whereas serogroups A and 29E were only seen in cases of nonrecurrent meningitis. Patients with recurrent meningococcal disease may have defects in the complement system [46][47][48][49]. At least 13 of these 99 episodes occurred in 6 individuals with a complement defect [50].…”

Adhesin genes and serum resistance in Haemophilus influenzae type f isolates

“…Invasive disease associated with Hif appears to disproportionately affect individuals with underlying co-morbidities, including adults suffering from chronic obstructive pulmonary disease (COPD), ethanol abuse, chronic renal disease and human immunodeficiency virus/AIDS, and children with immunoglobulin deficiencies, severe combined immunodeficiency, human immunodeficiency virus/ AIDS, malignancy and sickle-cell disease (Nitta et al, 1995;Urwin et al, 1996;Fickweiler et al, 2004;Resman et al, 2011b;Watson et al, 2011). This is in contrast to Hib, which is considered a primary pathogen able to cause disease in otherwise healthy and immunocompetent individuals, predominantly children (Morris et al, 2008 (St Geme et al, 1993, 1996Mhlanga-Mutangadura et al, 1998), PCR analysis of variability at a lipo-oligosaccharide (LOS) biosynthetic island, and assessment of their ability to resist the bactericidal activity of adult normal human serum (NHS).…”

“…(Takala et al, 1991;Urwin et al, 1996;Ward, 1996;Tsang, 2007). In fact, several investigations in North America and Europe in the post-conjugate vaccine era have indicated an increased incidence, albeit small, of invasive infections due to non-b H. influenzae, with a predominance of nontypable and Hif strains, primarily in older age groups (Urwin et al, 1996;Ladhani et al, 2010Ladhani et al, , 2012MacNeil et al, 2011;Resman et al, 2011a; Rubach et al, 2011;Ladhani, 2012).Invasive disease associated with Hif appears to disproportionately affect individuals with underlying co-morbidities, including adults suffering from chronic obstructive pulmonary disease (COPD), ethanol abuse, chronic renal disease and human immunodeficiency virus/AIDS, and children with immunoglobulin deficiencies, severe combined immunodeficiency, human immunodeficiency virus/ AIDS, malignancy and sickle-cell disease (Nitta et al, 1995;Urwin et al, 1996;Fickweiler et al, 2004;Resman et al, 2011b;Watson et al, 2011). This is in contrast to Hib, which is considered a primary pathogen able to cause disease in otherwise healthy and immunocompetent individuals, predominantly children (Morris et al, 2008 (St Geme et al, 1993, 1996Mhlanga-Mutangadura et al, 1998), PCR analysis of variability at a lipo-oligosaccharide (LOS) biosynthetic island, and assessment of their ability to resist the bactericidal activity of adult normal human serum (NHS).…”