Invasive Haemophilus influenzae Infections in Older Children and Adults in Seattle

We recently saw two unusual manifestations of Haemophilus influenzae infection in adults in the Seattle area: fulminant sepsis in an otherwise-healthy man and three episodes of bacteremia in a woman with chronic liver disease. We retrospectively identified 79 bacteremic and 40 non-bacteremic cases o...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 17; no. 3; pp. 389 - 396
Main Authors:	Kostman, Jay R., Sherry, Betty Lou, Fligner, Corinne L., Egaas, Susan, Sheeran, Paul, Baken, Leslie, Bauwens, J. Eric, Clausen, Carla, Sherer, David M., Plorde, James J., Stull, Terrence L., Mendelman, Paul M.
Format:	Journal Article
Language:	English
Published:	United States The University of Chicago Press 01-09-1993 University of Chicago Press
Subjects:	Adolescent Adult Adults Bacteremia Bacteremia - epidemiology Bacterial pneumonia Child Clinical Infectious Disease Articles Epidemiology Female Haemophilus Infections - epidemiology Haemophilus Infections - mortality Haemophilus influenzae Haemophilus influenzae type b Humans Infections Male Mortality Nervous system diseases Older adults Retrospective Studies Washington - epidemiology Washington USA, Washington, Seattle
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Summary:	We recently saw two unusual manifestations of Haemophilus influenzae infection in adults in the Seattle area: fulminant sepsis in an otherwise-healthy man and three episodes of bacteremia in a woman with chronic liver disease. We retrospectively identified 79 bacteremic and 40 non-bacteremic cases of invasive H. influenzae infection developing in patients ⩾9 years of age between 1 January 1980 and 31 December 1990. The most common clinical presentations among patients with bacteremia included pneumonia (52%), septicemia (27%), meningitis (8%), gynecologic infection (5%), and epiglottitis (5%). Underlying illnesses were common in these patients, and overall mortality was 35.5%. Factors associated with mortality included underlying neurological disease, polymicrobial bacteremia, and advanced age. The clinical presentations of the 40 patients without bacteremia included soft-tissue abscesses (45%), lung abscesses (18%), peritonitis (13%), meningitis (8%), gynecologic infection (8%), epididymitis (5%), mastoiditis (3%), and osteomyelitis (3%). Thus H. influenzae disease has a variety of presentations and is associated with significant mortality in older children and adults. Further study is required to determine whether widespread administration of H. influenzae type b conjugate vaccine to infants will alter the development of subsequent disease in later life.
Bibliography:	istex:50848BD1AFED1B3E8F16CC926A86044065F68DF0 ark:/67375/HXZ-CGN1K9LP-G Present affiliation: Group Health, Inc., Minneapolis, Minnesota. Reprints or correspondence: Dr. Jay R. Kostman, Cooper Hospital/University Medical Center, Education and Research Building, Room 268, 401 Haddon Avenue, Camden, New Jersey 08103. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Case Study-2 ObjectType-Feature-4 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1058-4838 1537-6591
DOI:	10.1093/clinids/17.3.389