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JMM Case Reports JMM Case Reports

Volume 1, Issue 3

A case of acute epiglottitis caused by type a in an adult Open Access

Abstract

Introduction:

Prior to the introduction of a paediatric conjugate vaccine in the early 1990s, serotype b (Hib) was a major cause of childhood meningitis and pneumonia. Since becoming part of national immunization programmes, the Hib conjugate vaccine has been very successful in preventing invasive Hib disease worldwide. However, in the post‐Hib vaccine era, the emergence of invasive disease caused by non‐type b has been reported from several countries. Previous studies by our group found an increased incidence of invasive disease caused by serotype a in Northwestern Ontario, Canada, during 2002–2011. Most of the cases of invasive type a disease occurred in young children.

Case presentation:

Our continued surveillance identified a case of epiglottitis caused by type a in a 65‐year old woman. This life‐threatening condition was historically associated with invasive Hib disease in young children but had not previously been reported in association with type a. We describe the clinical presentation of this case as well as characteristics of the type a isolate.

Conclusion:

Our findings stress the importance of continued surveillance of in the post Hib‐vaccine era, and point to the significance of type a as a cause of severe invasive disease in countries with a universal paediatric anti‐Hib immunization programme.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): epiglottitis and Haemophilus influenzae
© 2014 The Authors
  • This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/).
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2014-09-01
2025-04-19
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References

  1. Adam H.J., Richardson S.E., Jamieson F.B., Rawte P., Low D.E., Fisman D.N. ( 2010). Changing epidemiology of invasive Haemophilus influenzae in Ontario, Canada: evidence for herd effects and strain replacement due to Hib vaccination. Vaccine 28:4073–4078 [CrossRef]
     [Google Scholar]
  2. Aravapalli S., Sahai S. ( 2013). Haemophilus influenzae type f epiglottitis in a 3‐year‐old boy. Consultant Pediatricians 12:263–265
     [Google Scholar]
  3. Brown V.M., Madden S., Kelly L., Jamieson F.B., Tsang R.S., Ulanova M. ( 2009). Invasive Haemophilus influenzae disease caused by non‐type b strains in Northwestern Ontario, Canada, 2002–2008. Clin Infect Dis 49:1240–1243 [CrossRef]
     [Google Scholar]
  4. Bruce M.G., Deeks S.L., Zulz T., Navarro C., Palacios C., Case C., Hemsley C., Hennessy T., Corriveau A. other authors( 2008). Epidemiology of Haemophilus influenzae serotype a, North American Arctic, 2000–2005. Emerg Infect Dis 14:48–55 [CrossRef]
     [Google Scholar]
  5. Bruce M.G., Zulz T., Debyle C., Singleton R., Hurlburt D., Bruden D., Rudolph K., Hennessy T., Klejka J., Wenger J.D. ( 2013). Haemophilus influenzae serotype a invasive disease, Alaska, USA, 1983–2011. Emerg Infect Dis 19:932–937 [CrossRef]
     [Google Scholar]
  6. Chalmers C. ( 2010). Necrotising fasciitis complicating Haemophilus influenzae type b epiglottitis in an adult. J Laryngol Otol 124:807–809 [CrossRef]
     [Google Scholar]
  7. Chandler D., Connor M., Breen D. ( 2009). Hib epiglottitis despite fully vaccinated status. Br J Gen Pract 59:597–598 [CrossRef]
     [Google Scholar]
  8. Charuvanij S., Houghton K.M. ( 2009). Acute epiglottitis as the initial presentation of pediatric systemic lupus erythematosus. Pediatr Rheumatol Online J 7:19 [CrossRef]
     [Google Scholar]
  9. CLSI( 2011). Performance Standards for Antimicrobial Susceptibility Testing; 21st informational supplement M100‐S21 Wayne, Pennsylvania: Clinical and Laboratory Standards Institute;
     [Google Scholar]
  10. Falla T.J., Crook D.W., Brophy L.N., Maskell D., Kroll J.S., Moxon E.R. ( 1994). PCR for capsular typing of Haemophilus influenzae . J Clin Microbiol 32:2382–2386
     [Google Scholar]
  11. Frantz T.D., Rasgon B.M., Quesenberry C.P. Jr ( 1994). Acute epiglottitis in adults. Analysis of 129 cases. JAMA (J Am Med Ass) 272:1358–1360 [CrossRef]
     [Google Scholar]
  12. Hopkins A., Lahiri T., Salerno R., Heath B. ( 2006). Changing epidemiology of life‐threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics 118:1418–1421 [CrossRef]
     [Google Scholar]
  13. Jiang J.H., Chiu N.C., Lin Y.Y., Lee K.S., Lee H.C., Huang F.Y. ( 2003). Acute epiglottitis caused by Haemophilus influenzae type b: a case report. J Microbiol Immunol Infect 36:69–71
     [Google Scholar]
  14. Kelly L., Tsang R.S., Morgan A., Jamieson F.B., Ulanova M. ( 2011). Invasive disease caused by Haemophilus influenzae type a in Northern Ontario First Nations communities. J Med Microbiol 60:384–390 [CrossRef]
     [Google Scholar]
  15. Kilian M. ( 2003). Haemophilus. In Manual of Clinical Microbiology, 8th, edn Edited by, Edited by Murray P., Baron E., Jorgensen J., Pfaller M., Yolken R. Washington, DC: ASM Press;p. 623–635
     [Google Scholar]
  16. Kroll J.S., Loynds B., Brophy L.N., Moxon E.R. ( 1990). The bex locus in encapsulated Haemophilus influenzae: a chromosomal region involved in capsule polysaccharide export. Mol Microbiol 4:1853–1862 [CrossRef]
     [Google Scholar]
  17. Kroll J.S., Loynds B.M., Moxon E.R. ( 1991). The Haemophilus influenzae capsulation gene cluster: a compound transposon. Mol Microbiol 5:1549–1560 [CrossRef]
     [Google Scholar]
  18. Kroll J.S., Moxon E.R., Loynds B.M. ( 1994). Natural genetic transfer of a putative virulence‐enhancing mutation to Haemophilus influenzae type a. J Infect Dis 169:676–679 [CrossRef]
     [Google Scholar]
  19. Ladhani S., Slack M.P., Heath P.T., von Gottberg A., Chandra M., Ramsay M.E. European Union Invasive Bacterial Infection Surveillance participants( 2010). Invasive Haemophilus influenzae disease, Europe, 1996–2006. Emerg Infect Dis 16:455–463 [CrossRef]
     [Google Scholar]
  20. Lau S.K., Woo P.C., Mok M.Y., Teng J.L., Tam V.K., Chan K.K., Yuen K.Y. ( 2004). Characterization of Haemophilus segnis, an important cause of bacteremia, by 16S rRNA gene sequencing. J Clin Microbiol 42:877–880 [CrossRef]
     [Google Scholar]
  21. Lima J.B., Ribeiro G.S., Cordeiro S.M., Gouveia E.L., Salgado K., Spratt B.G., Godoy D., Reis M.G., Ko A.I., Reis J.N. ( 2010). Poor clinical outcome for meningitis caused by Haemophilus influenzae serotype A strains containing the IS1016‐ bexA deletion. J Infect Dis 202:1577–1584 [CrossRef]
     [Google Scholar]
  22. Lipsitch M. ( 1997). Vaccination against colonizing bacteria with multiple serotypes. Proc Natl Acad Sci U S A 94:6571–6576 [CrossRef]
     [Google Scholar]
  23. Mcvernon J., Trotter C.L., Slack M.P., Ramsay M.E. ( 2004). Trends in Haemophilus influenzae type b infections in adults in England and Wales: surveillance study. Br Med J 329:655–658 [CrossRef]
     [Google Scholar]
  24. Meats E., Feil E.J., Stringer S., Cody A.J., Goldstein R., Kroll J.S., Popovic T., Spratt B.G. ( 2003). Characterization of encapsulated and noncapsulated Haemophilus influenzae and determination of phylogenetic relationships by multilocus sequence typing. J Clin Microbiol 41:1623–1636 [CrossRef]
     [Google Scholar]
  25. Morris S.K., Moss W.J., Halsey N. ( 2008). Haemophilus influenzae type b conjugate vaccine use and effectiveness. Lancet Infect Dis 8:435–443 [CrossRef]
     [Google Scholar]
  26. PHAC( 2012). Public Health Agency of Canada. Invasive Haemophilus Influenzae Disease. http://www.phac-aspc.gc.ca/im/vpd-mev/hib-eng.php (Accessed October 18, 2013)
    [Google Scholar]
  27. Pittman M. ( 1931). Variation and type specificity in the bacterial species Haemophilus influenzae. . J Exp Med 53:471–492 [CrossRef]
     [Google Scholar]
  28. Ribeiro G.S., Reis J.N., Cordeiro S.M., Lima J.B., Gouveia E.L., Petersen M., Salgado K., Silva H.R., Zanella R.C., Almeida S.C. other authors( 2003). Prevention of Haemophilus influenzae type b (Hib) meningitis and emergence of serotype replacement with type a strains after introduction of Hib immunization in Brazil. J Infect Dis 187:109–116 [CrossRef]
     [Google Scholar]
  29. Ribeiro G.S., Lima J.B., Reis J.N., Gouveia E.L., Cordeiro S.M., Lobo T.S., Pinheiro R.M., Ribeiro C.T., Neves A.B. other authors( 2007). Haemophilus influenzae meningitis 5 years after introduction of the Haemophilus influenzae type b conjugate vaccine in Brazil. Vaccine 25:4420–4428 [CrossRef]
     [Google Scholar]
  30. Rogers D.J., Sie K.C., Manning S.C. ( 2010). Epiglottitis due to nontypeable Haemophilus influenzae in a vaccinated child. Int J Pediatr Otorhinolaryngol 74:218–220 [CrossRef]
     [Google Scholar]
  31. Rotondo J., Sherrard L., Helferty M., Tsang R., Desai S. ( 2013). The epidemiology of invasive disease due to Haemophilus influenzae serotype a in the Canadian North from 2000 to 2010. Int J Circumpolar Health 72:646–650 [CrossRef]
     [Google Scholar]
  32. Sadeghi‐Aval P., Tsang R., Jamieson F., Ulanova M. ( 2013). Emergence of non‐serotype b encapsulated Haemophilus influenzae as a cause of pediatric meningitis in northwestern Ontario. Can J Infect Dis Med Microbiol 24:13–16
     [Google Scholar]
  33. Salamanca Santamaria J., Lopez‐Rios F., Verdaguer Munoz J.M. ( 2011). [Acute fatal epiglottitis due to Haemophilus influenzae]. An Pediatr (Barc) 74, 195–196 (in Spanish)
     [Google Scholar]
  34. Senior B.A., Radkowski D., Macarthur C., Sprecher R.C., Jones D. ( 1994). Changing patterns in pediatric supraglottitis: a multi‐institutional review, 1980 to 1992. Laryngoscope 104:1314–1322 [CrossRef]
     [Google Scholar]
  35. Sill M.L., Law D.K., Zhou J., Skinner S., Wylie J., Tsang R.S. ( 2007). Population genetics and antibiotic susceptibility of invasive Haemophilus influenzae in Manitoba, Canada, from 2000 to 2006. FEMS Immunol Med Microbiol 51:270–276 [CrossRef]
     [Google Scholar]
  36. Sutton A., Schneerson R., Kendall‐Morris S., Robbins J.B. ( 1982). Differential complement resistance mediates virulence of Haemophilus influenzae type b. Infect Immun 35:95–104
     [Google Scholar]
  37. Takala A.K., Eskola J., Leinonen M., Kayhty H., Nissinen A., Pekkanen E., Makela P.H. ( 1991). Reduction of oropharyngeal carriage of Haemophilus influenzae type b (Hib) in children immunized with an Hib conjugate vaccine. J Infect Dis 164:982–986 [CrossRef]
     [Google Scholar]
  38. Tanner K., Fitzsimmons G., Carrol E.D., Flood T.J., Clark J.E. ( 2002). Haemophilus influenzae type b epiglottitis as a cause of acute upper airways obstruction in children. BMJ 325:1099–1100 [CrossRef]
     [Google Scholar]
  39. Tsang R. ( 2008). Changing epidemiology of invasive Haemophilus influenzae disease. Lancet Infect Dis 8:737 [CrossRef]
     [Google Scholar]
  40. Tsang R.S., Mubareka S., Sill M.L., Wylie J., Skinner S., Law D.K. ( 2006). Invasive Haemophilus influenzae in Manitoba, Canada, in the postvaccination era. J Clin Microbiol 44:1530–1535 [CrossRef]
     [Google Scholar]
  41. Tsang R.S., Sill M.L., Skinner S.J., Law D.K., Zhou J., Wylie J. ( 2007). Characterization of invasive Haemophilus influenzae disease in Manitoba, Canada, 2000–2006: invasive disease due to non‐type b strains. Clin Infect Dis 44:1611–1614 [CrossRef]
     [Google Scholar]
  42. Tsang R.S.W., Shuel M., Wylie J., Lefebvre B., Hoang L., Law D.K.S. ( 2013). Population genetics of Haemophilus influenzae serotype a in three Canadian provinces. Can J Microbiol 59:362–364 [CrossRef]
     [Google Scholar]
  43. Ulanova M. ( 2013). Global epidemiology of invasive Haemophilus influenzae type a disease: do we need a new vaccine?. J Vaccines 2013:1–14 [CrossRef]
     [Google Scholar]
  44. Ulanova M., Tsang R. ( 2014). Haemophilus influenzae serotype a as a cause of serious invasive infections. Lancet Infect Dis 14:70–82 doi: 10.1016/S1473‐3099(13)70170‐1
    [Google Scholar]
  45. Wenger J.D. ( 1998). Epidemiology of Haemophilus influenzae type b disease and impact of Haemophilus influenzae type b conjugate vaccines in the United States and Canada. Pediatr Infect Dis J 17:S132–S136 [CrossRef]
     [Google Scholar]
  46. Zwahlen A., Kroll J.S., Rubin L.G., Moxon E.R. ( 1989). The molecular basis of pathogenicity in Haemophilus influenzae: comparative virulence of genetically‐related capsular transformants and correlation with changes at the capsulation locus cap. Microb Pathog 7:225–235 [CrossRef]
     [Google Scholar]
/content/journal/jmmcr/10.1099/jmmcr.0.001552
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A case of acute epiglottitis caused by Haemophilus influenzae type a in an adult
JMM Case Rep 1, e001552 (2014); https://doi.org/10.1099/jmmcr.0.001552
/content/journal/jmmcr/10.1099/jmmcr.0.001552
/content/journal/jmmcr/10.1099/jmmcr.0.001552
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