Symptoms of Haemophilus influenzae infection in children

Pneumonia associated with H. influenzae accounts for about 5% of all patients with pneumonia; even more often, this pathogen is isolated from pleural exudate in patients with pleurisy. As a rule, children in the first 2 years of life are ill.

The disease begins acutely with a rise in body temperature to 39-40 °C, catarrhal symptoms and severe toxicosis. The symptoms are no different from other bacterial pneumonias. Percussion and auscultation reveal a focus of inflammation in the projection of one or more segments of the lungs. The process is most often localized in the root zones, but the lower and upper lobes of one or both lungs can be affected. Abscessing is possible. Radiographic changes are also not specific. In accordance with the clinical picture, foci of homogeneous darkening or dense focal-confluent shadows are detected in the case of exudative pleurisy.

Hemophilic meningitis is clinically manifested by the same symptoms as other purulent meningitis. The disease begins acutely with a rise in body temperature to 39-40 °C and the appearance of general infectious toxicosis with repeated vomiting, agitation, complete sleep disorder, tremor of the chin and hands. In children of the first months of life, hyperesthesia, bulging of the large fontanelle are noted, less often positive Kernig's, Brudzinsky's symptoms, and rigidity of the occipital muscles are observed. Changes in the cerebrospinal fluid are practically no different from those in meningococcal or pneumococcal meningitis.

Panniculitis (cellulitis, inflammation of fatty tissue) usually occurs in children aged 1 year. The disease begins with the appearance of dense painful areas of a bluish-red or purple color with a diameter of 1-10 cm or more in the head, neck, cheeks or periorbital region. There may be other manifestations of the disease at the same time: otitis, purulent meningitis, pneumonia, etc.

Acute epiglottitis, or inflammation of the epiglottis, is observed in children aged 2 to 5 years. It manifests itself as sharp pain in the throat, inability to swallow, severe shortness of breath, respiratory distress due to narrowing or even blockage of the larynx in the epiglottis area. Aphonia, profuse salivation, pallor, cyanosis, and flaring of the wings of the nose are also possible. Small children often throw their heads back in the absence of meningeal symptoms. In older children and adults, a sharply swollen cherry-red epiglottis can be seen when pressing on the root of the tongue. Direct laryngoscopy, in addition to damage to the epiglottis, reveals an inflammatory process in the subglottic space.

Hemophilic pericarditis accounts for up to 15% of all cases of pericarditis in children. Clinically, it is no different from pericarditis of other bacterial etiologies. The disease manifests itself as high body temperature, tachycardia, expansion of the boundaries of cardiac dullness, muffled heart sounds, respiratory disorders, etc.

In purulent arthritis of hemophilic etiology, large joints are usually affected: knee, elbow, hip, shoulder. Clinical manifestations of purulent arthritis do not differ from those of other bacterial etiologies.

Osteomyelitis caused by H. influenzae is clinically manifested by the same symptoms as osteomyelitis of other bacterial etiologies (staphylococcal, streptococcal, etc.). Large tubular bones are predominantly affected: the femur, tibia, and humerus. The diagnosis is established based on the results of bacteriological cultures of bone marrow aspirate, as well as the study of smears stained by Gram.

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