Haemophilus influenzae meningitis with prolonged hospital course.
A retrospective evaluation of Haemophilus influenzae type b meningitis observed over a 2-year period documented 86 cases. Eight of these patients demonstrated an unusual clinical course characterized by persistent fever (duration: greater than 10 days), cerebrospinal fluid pleocytosis, profound meningeal enhancement on computed tomography, significant morbidity, and a prolonged hospital course. The mean age of these 8 patients was 6 months, in contrast to a mean age of 14 months for the entire group. Two patients had clinical evidence of relapse. Four of the 8 patients tested for latex particle agglutination in the cerebrospinal fluid remained positive after 10 days. All patients received antimicrobial therapy until they were afebrile for a minimum of 5 days. Subsequent neurologic examination revealed a persistent seizure disorder in 5 patients (62.5%), moderate-to-profound hearing loss in 2 (25%), mild ataxia in 1 (12.5%), and developmental delay with hydrocephalus which required shunting in 1 (12.5%). One patient had no sequelae.
Martin
L D
LD
Division of Pediatrics, Phoenix Children's Hospital, Arizona 85006.
Kaplan
A M
AM
Rudinsky
M F
MF
Frost
M D
MD
D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000209:etiology*; D001929:Brain Edema / Q000209:etiology; D002552:Cerebral Ventricles / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006193:Haemophilus influenzae / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008583:Meningitis, Haemophilus / Q000150:complications*; D014057:Tomography, X-Ray Computed