Alwayel Zahraa A, Alghamdi Asail S, AlmohammedSaleh Jumanah A, Almohammed Salah, Almatawah Yameen
Medical School, King Faisal University, Al Ahsa, SAU.
College of Medicine, Albaha University, Al Baha, SAU.
Cureus. 2023 Feb 14;15(2):e34991. doi: 10.7759/cureus.34991. eCollection 2023 Feb.
is a gram-negative pleomorphic coccobacillus associated with many diseases, such as meningitis, pneumonia, septicemia, cellulitis, and otitis media. The most virulent and most common serotype is type b (Hib), which was responsible for the majority of meningitis cases until the development of vaccines that led to a decrease in its incidence worldwide. Here, we report the case of an 11-month-old female infant who was previously healthy and fully vaccinated against Hib and developed sepsis and meningitis. The patient was managed as a case of partially treated bacterial meningitis but failed to respond to a short-duration course of antibiotics and had focal seizures of the left hand. Non-contrast brain MRI revealed multiple and bilateral brain abscesses more evident on the left side. The patient was then followed up with imaging every 10-14 days to monitor the response and resolution of the brain abscesses. She was successfully treated with a full course of intravenous ceftriaxone for six weeks until imaging was clear and the brain abscesses were nearly undetected. Invasive infections are considered emerging cases, and there is a need to consider and suspect the disease even in fully vaccinated patients.
是一种革兰氏阴性多形性球杆菌,与许多疾病相关,如脑膜炎、肺炎、败血症、蜂窝织炎和中耳炎。最具毒性且最常见的血清型是b型(Hib),在导致全球发病率下降的疫苗研发出来之前,它是大多数脑膜炎病例的病因。在此,我们报告一例11个月大的女婴病例,该女婴此前健康且已完全接种Hib疫苗,却患上了败血症和脑膜炎。该患者被作为部分治疗的细菌性脑膜炎病例进行处理,但对抗生素短期疗程无反应,且左手出现局灶性癫痫发作。脑部非增强MRI显示双侧多发性脑脓肿,左侧更为明显。随后每10 - 14天对患者进行一次影像学随访,以监测脑脓肿的反应和消退情况。她成功接受了为期六周的静脉注射头孢曲松全疗程治疗,直至影像学检查结果清晰且脑脓肿几乎未被检测到。侵袭性感染被视为新出现的病例,即使在完全接种疫苗的患者中也需要考虑并怀疑这种疾病。