Which clinical history findings are characteristic of fulminant Haemophilus influenzae type b (Hib) meningitis?

Updated: Jul 09, 2018
  • Author: Prateek Lohia, MD, MHA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Occasionally, children present with the report of fulminant deterioration in mental status, with or without seizures, sometimes after cardiopulmonary arrest. In fulminant cases, medical attention is often sought because of medical emergencies such as coma or status epilepticus.

Infants younger than 2 months very seldom develop Hib meningitis, justifying in part the current vaccination schedule for children. In the rare instances when these very young infants do develop Hib meningitis, their manifestations tend to be fulminant, even if no contemporary evidence exists for an epidemic due to a particularly virulent Hib strain.

Presentations in these cases suggest sepsis because the infants tend to be moribund with high fever. Meningismus may or may not be found. Pneumonia with pneumatocele formation, pericarditis, or osteomyelitis may further complicate the diagnosis and management of these severely ill infants.


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