Haemophilus meningitis in an African neonate: time for active surveillance and institution of appropriate control measure
Adeboye, M.A.; Obasa, T.O.; Fadeyi, A.; Adesiyun, O.O.; Mokuolu, O.A.
West African Journal of Medicine 29(4): 275-277
2010
ISSN/ISBN: 0189-160X PMID: 20931518 Document Number: 537462
Childhood routine immunization in Nigeria, like most developing nations, do not include vaccination against Haemophilus influenzae type b (Hib) infection. This is probably because infection with Hib is uncommon in children younger than two months due to passive acquisition of maternal antibodies which protects newborn till about four to six months of life. To illustrate a case of neonatal meningitis caused by Haemophilus influenzae and to highlight its other peculiarities. A 22-day old baby presented with excessive crying, refusal of feed, progressive abdominal distension, fever and vomiting. Besides clinical assessment, body fluids were cultured. The baby had tachypnoea (90 bpm), tachycardia (182 bpm), and tympanitic and hypoactive abdomen. The musculoskeletal and central nervous systems appeared clinically normal. Haemophilus influenzae was isolated by culture from the cerebrospinal fluid. The baby responded well to treatment with ceftriaxone and gentamycin. Neurological examination has remained normal after discharge for up to three months at follow-up visit. There is the need to provide serological and molecular facilities for typing Nigerian Haemophilus infulenzae strain(s) to enhance the development of appropriate vaccine that will be most suitable for prevention of infection due to this organism in Nigeria. However, presently available Haemophilus influenzae vaccine needs to be listed in the National Programme for Immunization (NPI) for the control of infections associated with this organism especially in childhood.