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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Report on two deaths from a natural internal cause in children beyond the first year of life. The children (a two-year and a three-year old boy), who seemed completely healthy, sudden suffered from acute inflammation of the upper respiratory tract with dyspnea, inspiratory stridor, fever, dysphagia, and flow of saliva. The disease took a fulminant course and the children died within a few hours showing symptoms of intense dyspnea and cyanosis. The above symptoms and progress were typical of acute epiglottitis. Autopsy revealed an intense inflammation and tumescence of the epiglottis in both cases. The diagnosis of epiglottitis was confirmed histologically and bacteriologically (Haemophilus influenzae).
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PMID:[Unexpected fatalities in childhood caused by acute epiglottitis]. 148 25

In a retrospective analysis of 2110 admissions to the pediatric intensive care unit, 564 cases of septic shock were identified (26.7% of the total admissions). Septic shock was defined in patients with: (1) clinical evidence of sepsis; (2) fever (greater than 38.3 degrees C) or hypothermia (less than 35.6 degrees C); (3) tachycardia; (4) tachypnea; and (5) inadequate organ perfusion. Inadequate perfusion was defined as hypotension or evidence of peripheral hypoperfusion (poor capillary refill or cyanosis with hypoxemia, oliguria, acidosis or altered mentation). Inotropic support was required to maintain an adequate blood pressure and perfusion in 268 of 564 patients (47.5%). Septic shock with confirmed bacterial infection occurred in 143 patients (143 of 564, 25.2%); these cases were caused by Haemophilus influenzae, type b (59 of 143, 41.3%), Neisseria meningitidis (26 of 143, 18.2%) and Streptococcus pneumoniae (16 of 143, 11.2%). Eight of 564 (1.4%) cases of septic shock were not clinically apparent on initial evaluation and were diagnosed within 24 hours after admission to the hospital. We conclude that septic shock occurs more frequently in children than previously appreciated and may develop after admission to the hospital.
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PMID:Septic shock in children: bacterial etiologies and temporal relationships. 233

A previously healthy 19-year-old woman had a febrile illness with hypotension, progressive cyanosis, and an evolving petechial rash. Despite aggressive therapy in the face of shock and disseminated intravascular coagulation, the patient suffered a cardiac arrest and could not be resuscitated. Haemophilus influenzae type b was cultured from the blood and echovirus 30 from the cerebrospinal fluid post mortem. Fulminant H influenzae type b infection in an immunocompetent adult is rare but should be recognized as a possible cause of the Waterhouse-Friderichsen syndrome.
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PMID:Waterhouse-Friderichsen syndrome caused by Haemophilus influenzae type b in an immunocompetent young adult. 259 28

Fever is one of the most frequent signs seen in children at consultation. In infants under the age of 3 months, fever is nonspecific and is often the only sign of a potentially severe infection. It has been estimated that two-thirds of the children hospitalized have a viral infection and 10% a bacterial infection with risks of complications including meningitis. It must be recalled that 5% of the infants with septicaemia due to Haemophilus influenzae b who does not receive an appropriate treatment will develop meningitis or another focal infection. There is agreement on the definition of potentially severe infections: meningitis, osteoarthritis, cellulitis or cellulodermitis, urinary infection, lung infection and gastroenteritis. Certain authors also include inner ear infections. In suspected cases, the need for hospitalization can be based on signs of impaired consciousness and/or muscle tone, abnormal heart rate, blood pressure or recoloration time, paleness, cyanosis, respiratory distress, signs of dehydration, or abnormal behaviour. In order to identify infants at low risk, in addition to the physical examination, the clinician can rely on essential laboratory tests: white cell count with differential count, blood culture, C-reactive protein and/or sedimentation rate with fibrinogen and an urinanalysis. A chest X-ray is required in case of respiratory signs and a culture of the fecal matter is needed in case of diarrhoea. On the basis of these findings and the clinical picture, if the criteria of low risk of bacterial infection are fulfilled in an infant under 3 months of age with fever, most authors agree that a spinal tap must nevertheless be performed. When these tests lead to the conclusion of low risk, close surveillance at home is appropriate. If the clinical picture worsens within 24h hospitalization is required.
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PMID:[Fever in infants under the age of three months without sign of focal infection. Criteria of therapeutic decision]. 807 34

Underlying diseases, complications, clinical findings, and laboratory findings were evaluated in 158 cases of septicaemia admitted to Jikei University Hospital from 1975 to 1994, in order to conjectured factors that prescribe for the prognosis. 50% of the patients had underlying diseases. Malignancy including leukaemia (31 cases, 39.2%) was the most common underlying disease, followed by low birth weight infant (17 cases, 21.5%), aplastic anemia (9 case, 11.4%), and congenital heart disease (7 cases, 8.9%). The death rate for patients with underlying disease (27.8%) was significantly greater than the mortality for normal patients with septicaemia (8.9%) (p < 0.05). Meningitis (24.7%) was the most common complication, followed by DIC (19.6%), shock (15.2%), and pneumonia (10.8%). The mortality rate of septicaemia complicated by shock was 66.7% (p < 0.01), and that complicated by DIC was 45.2% (p < 0.01). The mortality rate for patients with the clinical findings of respiratory distress, cough, abdominal distention, cyanosis, splenomegaly, or peripheral coldness was more than 40% and significantly greater (p < 0.01). Mortality rate in patients with granulocyte counts of < 4.000/mm3, platelet counts of < 5 x 10(4)/ mm3, total protein of < 5.0 g/dl, or ESR of < 20 mm/hr were significantly greater (p < 0.01) than those in patients with normal laboratory findings. Coincidence rate of blood and stool cultures was 57.9% for E. coli, and 28.6% for Klebsiella sp., and that of blood and throat cultures was more than 30% for Pseudomonas sp., Haemophilus influenzae, and Staphylococcus aureus. In the study of antimicrobial susceptibility for microorganisms isolated, the number of drug resistant S. aureus had increased in the last 10 years.
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PMID:[Study on septicaemia in infants and children in the past 20 years. Part 2. An analysis of factors that prescribe for the prognosis]. 889 May 45

Acute lower respiratory tract (ALRT) infections cause considerable child morbidity and mortality in developing countries. Oxygen therapy can improve the outcome of children with moderate or severe ALRT infections and, in those with hypoxemia, the severity of hypoxia correlates with outcome. However, since oxygen is not always available in resource-poor countries, rational guidelines must be followed for the use of oxygen and the referral of patients to specialist hospitals. Findings are presented from a prospective cohort study conducted to determine which clinical signs predict hypoxemia and the outcome of hypoxemia among children admitted to hospital with ALRT infection. Findings are based upon the study of 1072 of 42,848 children aged 2-33 months who were enrolled in a randomized trial of a Haemophilus influenzae type b vaccine in western Gambia, and who were admitted with an ALRT infection to 2 of 3 hospitals. 63 (5.9%) had an arterial oxygen saturation level of less than 90%. Logistic regression found cyanosis, a rapid respiratory rate, grunting, head nodding, absence of a history of fever, and no spontaneous movement during examination were significantly associated with hypoxemia. When cyanosis may not be correctly assessed, the inability to cry, head nodding, and a respiratory rate of at least 90 breaths/minute can be useful ways of predicting hypoxemia. Hypoxemic children were 5 times more likely to die than were nonhypoxemic children. The presence of malaria parasitemia had no effect upon the prevalence of hypoxemia or upon its association with respiratory rate.
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PMID:Clinical predictors of hypoxaemia in Gambian children with acute lower respiratory tract infection: prospective cohort study. 1039 Apr 81

It was previously shown that children with congenital heart disease (CHD) harbored Hemophilus, Actinobacillus, Cardiobacter, Eikenella, and Kingella (HACEK) microbes to a greater extent and had more severe gingival inflammation than a normal group of children. The purpose of this study was to determine if HACEK microbes are more prevalent in children with CHD than in normal children when there is no difference in gingival inflammation. Two groups of 12 children were matched with respect to gingival inflammation. Each child had a gingival index recorded as described by Massler. The experimental group consisted of 12 children with CHD 2.5-10 years old (average 5.5) and the control group consisted of 12 healthy children 2-13 years old (average 5.6). Subgingival samples were obtained and cultured for HACEK microbes. Fischer's exact test was performed with the significance level defined at P<0.05. The average gingival indices for the experimental and control groups were 6.5 and 6.4, respectively (N.S.). Nine of 12 children with CHD had Eikenella corrodens (E.c.) compared to 3/12 control patients ( P<0.05). Three of 12 CHD patients but no control patient had Actinobacillus actinomycetemcomitans (A.a.) (N.S.). There were no significant differences in E.c. or A.a. presence between cyanotic and acyanotic CHD patients. This study found that the greater extent of specific HACEK microbes harbored by children with CHD is not associated with cyanosis or the degree of gingival inflammation. Further study is needed to delineate fully the medical significance of this observation.
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PMID:Gingival colonization with selective HACEK microbes in children with congenital heart disease. 1267 36

Sixty-eight children with acute purulent meningitis were treated at The Hospital for Sick Children, Toronto, in 1962; nine deaths occurred. Hemophilus influenzae type B and meningitis in which no organism was cultured accounted for 35 and 17 cases, respectively. A number of other etiological agents caused six or fewer cases each.The principal presenting complaints were fever and vomiting, the more familiar symptoms of meningeal irritation occurring in 20% or less. A short duration of onset suggested a more severe illness and graver prognosis. Seven of the nine fatal cases had a presenting history of less than 24 hours' duration. Persisting high fever, convulsions, cyanosis and abdominal distension were also associated more specifically with the fatal cases.The laboratory examination of the initial spinal fluid sample, while of value in the identification of the causative organism, was not of prognostic value.The value of general treatment measures, as well as specific therapy, was evident in all cases.
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PMID:ACUTE PURULENT MENINGITIS IN CHILDREN: EXPERIENCE AT THE HOSPITAL FOR SICK CHILDREN, TORONTO. 1412 87

The pharmacovigilance of vaccines has the particularity of concerning medications with a preventative target, used in healthy subjects, who are often young. Their individual benefit is deferred and unknown, whereas their risk is immediate. Certain undesirable effects are linked to the antigen of live attenuated vaccines (post-MMR lymphocytic meningitis). Other non-specific effects are linked to other different components of the vaccines (macrophage and aluminium myofasciitis). Undesirable events susceptible to being due to the vaccination are identified and managed according to standardised procedures of pharmacovigilance, that is to say, based on "spontaneous notification", generation of an alert, confirmed or not by studies of pharmaco-epidemiology. The studies of pharmaco-epidemiology: have made evident oedematous reactions with cyanosis or purpura, with the vaccines containing the Haemophilus b valence, and the absence of an association with sudden death of the newborn; have excluded the existence of an elevated risk of demyelinisation or auto-immune disease associated with vaccination against hepatitis B, without being able to exclude a slight risk; go against the finding of an association between Crohn's disease and/or autisim and the MMR vaccination. Only their frequently encountered undesirable effects are well identified at the moment of commercialisation. Post-marketing surveillance of vaccines (declaration to the regional pharmacovigilance centres) allow the detection of possible rare and serious effects and the evaluation of the real vaccination risk. Thus it must be intensive and systematic.
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PMID:[Vaccines pharmacovigilance]. 1517 12

Febrile illness in children younger than 36 months is common and has potentially serious consequences. With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. Although an extensive diagnostic evaluation is still recommended for neonates, lumbar puncture and chest radiography are no longer recommended for older children with fever but no other indications. With an increase in the incidence of urinary tract infections in children, urine testing is important in those with unexplained fever. Signs of a serious bacterial infection include cyanosis, poor peripheral circulation, petechial rash, and inconsolability. Parental and physician concern have also been validated as indications of serious illness. Rapid testing for influenza and other viruses may help reduce the need for more invasive studies. Hospitalization and antibiotics are encouraged for infants and young children who are thought to have a serious bacterial infection. Suggested empiric antibiotics include ampicillin and gentamicin for neonates; ceftriaxone and cefotaxime for young infants; and cefixime, amoxicillin, or azithromycin for older infants.
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PMID:Evaluation of fever in infants and young children. 2341 97


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