Nuchal rigidity suggests meningitis. The recommended dose for dexamethasone in adults and children is 0.6 mg/kg/d for 4 days. H. influenzae serotype b strains remain a common cause of meningitis and other invasive infections, such as epiglotitis and bacteremia in countries that do not have Hib conjugate vaccine programs. In November 2007, a prospective randomized double-blind placebo-controlled trial studied adjuvant glycerol and dexamethasone in children with bacterial meningitis. Prospective evaluation of a high multiplexing real-time polymerase chain reaction array for the rapid identification and characterization of bacteria causative of nosocomial pneumonia from clinical specimens: a proof-of-concept study. [23], Unencapsulated H. influenzae is often observed in the airways of patients with chronic obstructive pulmonary disease (COPD). [95]. Clin Infect Dis. [Medline]. This site complies with the HONcode standard for trustworthy health information: verify here. 27th ed. 330(7481):18-9. Despite its name, it is not related to influenza (‘the flu’). The bacteria may cause two severe, often fatal infections: Epiglottitis (infection of the flap of tissue over the voice box). Certain adults at increased risk for Hib infection (patients with anatomical or functional asplenia or sickle cell diseases or who are undergoing elective splenectomy should receive one dose of Hib vaccine) who have not previously received the vaccine, except individuals with human immunodeficiency (HIV) infection or individuals with a low risk for Hib infection. 1464-1482. Patients experience purulent nasal discharge, headache, and facial pain. Based on data from 18 randomized controlled trials, the authors concluded that all adults and children with acute bacterial meningitis in developed countries who have good access to medical care should receive adjuvant corticosteroids. PRP-OMP induces a good immune response after a single dose in infants, but antibody levels after 3 doses are lower than those induced by HbOC and PRP-T. In Levinthal medium, capsulated strains show distinctive iridescence. 2013 Dec. 32 (12):1381-2. [Medline]. 54 (8):e72-e112. Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of AmericaDisclosure: Nothing to disclose. [Medline]. 71 Suppl 1:i21-31. 1994 Apr. Singleton R, Hammitt L, Hennessy T, et al. Advanced infections can cause potentially serious complications like meningitis, pneumonia, and sepsis. 357(24):2431-40. Zafar A, Hasan R, Nizamuddin S, Mahmood N, Mukhtar S, Ali F, et al. 17 (1):705. Ask your doctor or nurse for details. Clinicians should refer to the Centers for Disease Control and textbooks of medicine for details.). [Medline]. Lee S, Yen MT. 2016 May. Symptoms vary depending on the part of the body affected. [Medline]. Gilsdorf JR. What the pediatrician should know about non-typeable Haemophilus influenzae. Scarborough M, Gordon SB, Whitty CJ, et al. Haemophilus influenzae infections in adults: a pathogen in search of respect. 2005 Jan 1. Clin Infect Dis. Murphy, TF., Longo, DL, Fauci, AS, Kasper, DL, Hauser, SL, Jameson, JL, Loscalzo, J. [Medline]. In patients with Hib cellulitis, administer parenteral antibiotics until the patient shows defervescence and the cellulitis subsides. The healthy human respiratory tract is sterile below the vocal cords. Vaccine. [57], In one Japanese study, most H influenzae isolates collected from patients with acute urethritis and/or epididymitis were susceptible to ceftriaxone, fluoroquinolones, macrolides, and tetracyclines, based on the recommended MIC breakpoints (Clinical and Laboratory Standards Institute). Nontypeable Haemophilus influenzae and chronic obstructive pulmonary disease: a review for clinicians. Centers for Disease Control and Prevention. 2017 Sep 13. Optimal duration of antimicrobial therapy for uncomplicated Gram-negative bloodstream infections. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjE4MjcxLXRyZWF0bWVudA==. The bacteria can cause middle ear infections, sinusitis, and more serious infections, including meningitis and epiglottitis, as well as respiratory infections. Glycerol adjuvant therapy in adults with bacterial meningitis in a high HIV seroprevalence setting in Malawi: a double-blind, randomised controlled trial. The mechanisms of protective immunity to nontypeable strains are complex and incompletely understood. Van Damme P, Leroux-Roels G, Vandermeulen C, De Ryck I, Tasciotti A, Dozot M, et al. Patients with recurrent invasive Hib disease despite receiving Hib immunization should undergo immunologic evaluation.