title: [Pneumonia due to Haemophilus influenzae type b in children: presentation of 24 cases].
abstract: OBJECTIVE
  Due to the higher incidence in invasive infections, the changes observed in the sensitivity of this microorganism during the last decade and the seriousness of pulmonary infections in children, the objective of this paper is to review the clinical and epidemiological characteristics of Haemophilus influenzae type b (Hib) pneumonia, as well as to give an update of treatment.
  
  
  METHODS
  Twenty-four children diagnosed between 1973 and 1992 are reviewed using the following criteria: clinical manifestations of pneumonia, radiology and isolation of the microorganism.
  
  
  RESULTS
  The annual average was 7.8 cases/100,000 children under 5 years of age. More females were affected (58.3% vs 41.6%). Of the cases studied, 58.3% of the children were under one year and 83.3% under 2 years of age. Fever was the most common clinical manifestation (95.8%). Blood cultures were positive in 21 cases (87.5%); pleural effusion culture contributed to the diagnosis in two other cases (8.3%) and deep bronchial aspirate in one other case. Of the Haemophilus influenzae type b strains 62.5% were resistant to ampicillin and 100% were sensitive to second and third generation cephalosporins. Three infants with chronic illness died (12.5%).
  
  
  CONCLUSIONS
  Hib pneumonia is an infection usually affecting children younger than 2 years of age. Its clinical manifestations are indistinguishable from those of other microorganisms. Blood culture is the most useful technique to confirm the diagnosis. The increase in resistance to classical treatment (ampicillin) obliges us to consider amoxicillin-clavulanic as the selected empirical treatment. Second and third generation cephalosporins may be considered a good alternative. There is a high mortality in children with chronic illness.
authors.affiliation: Sección de Enfermedades Infecciosas Pediátricas, Hospital Infantil La Fe Valencia.
authors.forename: M C
authors.initials: MC
authors.lastname: Otero Reigada
authors.forename: B
authors.initials: B
authors.lastname: Ferrer Lorente
authors.forename: D
authors.initials: D
authors.lastname: Pérez Tamarit
authors.forename: M B
authors.initials: MB
authors.lastname: Ferrer Lorente
authors.forename: I
authors.initials: I
authors.lastname: Rodríguez Escribano
authors.forename: M
authors.initials: M
authors.lastname: Santos Durántez
authors.forename: F
authors.initials: F
authors.lastname: Asensi Botet
mesh_terms: D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D005260:Female; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007769:Lactams; D008297:Male; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology*; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D007769:Lactams