Clinical and laboratory characteristics of epiglottitis caused by Haemophilus influenzae type b in children

Abstract

BACKGROUND: Epiglottitis is an acute infectious disease accompanied by edema of the epiglottis, salivation, sore throat, and intoxication. In 95% of cases, the causative agent of epiglottitis in children is Haemophilus nfluenza type b (Hib). The relevance of the problem is that acute epiglottitis of Haemophilus etiology is not a localized, isolated disease of the ENT organs, but can result in development of an epiglottic abscess or phlegmon, as well as of other generalized forms of Hib infection, including sepsis.
 AIM: The aim of the study was to assess the incidence of epiglottitis caused by Hib in children and provide its clinical and laboratory characteristics.
 MATERIALS AND METHODS: We analyzed 23 cases of epiglottitis caused by Hib in children. The diagnosis was based on clinical and epidemiological data with mandatory verification by bacteriological, serological, and/or molecular biological methods.
 RESULTS: Epiglottitis was detected in 23 of 93 children with Hib infection who were treated at the Childrens Municipal Clinical Hospital No. 5 named after N.F. Filatov over the period from 2002 to 2016. Hib etiology of epiglottitis was confirmed mainly by the bacteriological method. All patients were prescribed ceftriaxone, which is the drug of choice for suspected Hib infection. Monotherapy was prescribed in 57% cases; two or more antibiotics were used in other cases (a course of 714 days).
 CONCLUSIONS: Epiglottitis is a severe, life-threatening disorder being a generalized Hib infection. Patients with epiglottitis should be prescribed antibiotics prior to confirmation of Hib etiology since Hib is the causative agent of epiglottitis in the vast majority of pediatric cases. Multiple methods should be used simultaneously to confirm the diagnosis. Bacteriological blood test made it possible to identify the pathogen in the overwhelming majority of patients. There were no risk factors for Hib infection and no important comorbidity.