Hemophilus Infections Health Article
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Medications
Hemophilus infections are treated with antibiotics. Patients who are severely ill are given ampicillin or a third-generation cephalosporin, such as cefotaxime or ceftriaxone, intravenously. Patients with milder infections are given oral antibiotics, including amoxicillin, cefaclor, erythromycin, or trimethoprim-sulfamethoxazole. Patients who are allergic to penicillin are usually given cefaclor or trimethoprim-sulfamethoxazole.
Patients with Hib strains that are resistant to ampicillin may be given chloramphenicol. Chloramphenicol is not a first-choice drug because of its side effects, including interference with bone marrow production of blood cells.
The duration of antibiotic treatment depends on the location and severity of the hemophilus infection. Adults with respiratory tract infections, or Hib pneumonia, are usually given a 10 to 14 day course of antibiotics. Meningitis is usually treated for 10 to 14 days, but a seven-day course of treatment with ceftriaxone appears to be sufficient for infants and children. Ear infections are treated for seven to 10 days.
Supportive care
Patients with serious hemophilus infections require bed rest and a humidified environment (such as a croup tent) if the respiratory tract is affected. Patients with epiglottitis frequently require intubation (insertion of a breathing tube) or a tracheotomy to keep the airway open. Patients with inflammation of the heart membrane, pneumonia, or arthritis may need surgical treatment to drain infected fluid from the chest cavity or inflamed joints.
Supportive care also includes monitoring of blood cell counts for patients using chloramphenicol, ampicillin, or other drugs that may affect production of blood cells by the bone marrow.
Prognosis
The most important factors in the prognosis are the severity of the infection and promptness of treatment. Untreated hemophilus infections—particularly meningitis, sepsis, and epiglottitis—have a high mortality rate. Bacterial sepsis of the newborn has a mortality rate of 13–50 percent. The prognosis is usually good for patients with mild infections who are treated without delay. Children who develop Hib arthritis sometimes have lasting problems with joint function.
Hemophilus vaccines
There are three different vaccines for hemophilus infections used to immunize children in the United States: PRP-D, HBOC, and PRP-OMP. PRP-D is used only in children older than 15 months. HBOC is administered to infants at two, four, and six months after birth, with a booster dose at 15 to 18 months. PRP-OMP is administered to infants at two and four months, with the third dose at the child's first birthday. All three vaccines are given by intramuscular injection. About 5 percent of children may develop fever or soreness in the area of the injection.
Other measures
Other preventive measures include isolating patients with respiratory hemophilus infections; treating appropriate contacts of infected patients with rifampin; maintaining careful standards of cleanliness in hospitals,
KEY TERMS
Bacteria—Singular, bacterium; tiny, one-celled forms of life that cause many diseases and infections.
Epiglottitis—Inflammation of the epiglottis, most often caused by a bacterial infection. The epiglottis is a piece of cartilage behind the tongue that closes the opening to the windpipe when a person swallows. An inflamed epiglottis can swell and close off the windpipe, thus causing the patient to suffocate. Also called supraglottitis.
Exudate—Cells, protein, fluid, or other materials that pass through cell or blood vessel walls. Exudates may accumulate in the surrounding tissue or may be discharged outside the body.
Intubation—A procedure in which a tube is inserted through the mouth and into the trachea to keep the airway open and to help a patient breathe.
Nosocomial infection—An infection acquired in a hospital setting.
Sepsis—A severe systemic infection in which bacteria have entered the bloodstream or body tissues.
Stridor—A term used to describe noisy breathing in general and to refer specifically to a high-pitched crowing sound associated with croup, respiratory infection, and airway obstruction.
Tracheotomy—An surgical procedure in which the surgeon cuts directly through the patient's neck into the windpipe below a blockage in order to keep the airway open.
See also Hib vaccine.
BOOKS
Daum, Robert S. "Haemophilus influenzae." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders, 2004.
St. Geme, Joseph W. "Haemophilus influenzae." In Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Oxford, UK: Church Livingston, 2002.
Rebecca J. Frey, PhD Rosalyn Carson-DeWitt, MD
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Author Info: Rebecca J. Frey PhD, Rosalyn Carson-DeWitt MD, Thomson Gale, Gale, Detroit, Gale Encyclopedia of Children's Health, 2006 |
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