Virtual Pediatric Hospital: ElectricAirway: Upper Airway Problems in Children: Discussion of H. Influenzae Type b
ElectricAirway: Upper Airway Problems in Children
Discussion of H. Influenzae Type b
Donna M. Santer, M.D., Michael P. D'Alessandro, M.D.
Peer Review Status: Externally Peer Reviewed by Lauren D Holinger, MD, Robert J. Winter, MD and the AMA
H. influenzae is a gram-negative coccobacillus, that is small and pleomorphic. They can be encapsulated (six strains are recognized and are designated a-f) or non-encapsulated and nontypeable. Invasive disease, such as meningitis, cellulitis, septic arthritis, pericarditis, or epiglottitis, is generally caused by encapsulated organisms most notably type b. Local respiratory tract disease, such as otitis media, bronchitis, and sinusitis, is generally caused by normal respiratory flora that include non-typeable H. influenzae. Asymptomatic colonization is frequent, and transmission is presumably from person to person via direct contact or inhalation of respiratory secretion droplets. The incubation period is unknown and has a biseasonal distribution (October-November and February-April). Invasive disease is generally seen in ages 3 months to 3 years, but epiglottitis has an older age range (2-7 years). At risk population includes city dwellers, day care attendees, American Indians and Eskimos, blacks, and patients with certain disease states such as asplenia, immunodeficiency syndromes, sickle cell anemia, and malignancies. Those children, especially less than 1 year of age, with documented invasive disease are at risk for recurrence. Treatment with antibiotics is indicated. (Report of the Committee on Infectious Diseases, American Academy of Pediatrics, Elk Grove Village, IL., 22nd Edit., 1991, pp. 220-229.)
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