Pediatric Haemophilus Influenzae Infection Treatment & Management

Updated: Apr 04, 2016
  • Author: Mobeen H Rathore, MD, CPE, FAAP, FIDSA; Chief Editor: Russell W Steele, MD  more...
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Treatment

Medical Care

Medical care depends on the disease syndrome. Children with invasive Haemophilus influenzae disease require careful attention and, often, intensive care. Medical care depends on the organ system or problems involved, as follows:

  • CNS: Lumbar puncture should be considered in a child with invasive H influenzae type b (Hib) disease. Complications, including subdural effusion, ventriculitis, infarction, abscess, sensorineural deafness, and developmental delay, must be considered.
  • Neonatal disease: Routine therapy with ampicillin and gentamicin for presumptive neonatal sepsis may not be effective if an ampicillin-resistant strain of Hib is the cause of the infection.
  • Meningitis: Prompt use of intravenous antibiotics and good supportive care are the mainstays of therapy.
  • Fluid and electrolyte disturbances: Seizures may be due to hyponatremia as a result of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The fluid status must be closely monitored in children with Hib meningitis, and the use of fluids, particularly hypo-osmolar fluids, on an ad-lib basis is contraindicated.
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Surgical Care

Consultation with a surgeon may be required in some children with invasive Hib disease. Procedures that may be necessary include the following:

  • Tracheotomy - For Hib epiglottitis when the airway cannot be managed with endotracheal intubation
  • Arthrocentesis or bone debridement - For osteomyelitis or septic arthritis, particularly involving the hip
  • Neurosurgery - For subdural empyema complicating meningitis or intracranial complications of orbital cellulitis [6]
  • Surgical drainage - For septic arthritis of the hip joint
  • Open drainage - For most cases of septic arthritis of the shoulder
  • Early pericardectomy - For pericarditis; the treatment of choice, used in conjunction with antibiotics
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Consultations

Depending on the manifestations of invasive H influenzae disease, consultants required may include neurologists, neurosurgeons, orthopedic surgeons, anesthesiologists, critical care physicians, and infectious diseases physicians. An audiologist should evaluate all children after they receive treatment for H influenzae meningitis.

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