Haemophilus influenzae infection
Introduction
Introduction to Haemophilus influenzae infection Hemophilus influenzae is a normal flora of the human upper respiratory tract. It has been mistaken for the pathogen of influenza in the past, but the actual pathogenic range is very wide, except for respiratory diseases. It can cause meningitis, sepsis, conjunctivitis, female genital tract infection, cellulitis, etc. It is not only a common pathogen of infants and young children, but also one of the pathogens of adult infection. basic knowledge Probability ratio: 67% of the population's disease probability Susceptible people: no special people Mode of infection: respiratory transmission Complications: appendicitis septic arthritis osteomyelitis epididymitis mastoiditis
Cause
Cause of Haemophilus influenzae infection
Bacteremia (30%):
The bacteria outside the body enter the blood system through the entrance of the body surface or the entrance to the infection, and then propagate in the blood of the human body and spread with the bloodstream throughout the body. The consequences are very serious. In general, a urinary catheter or a surgical stoma on the surface of the body is prone to bacteremia. Patients with bacteremia often develop acute metastatic infections of multiple organs and develop various acute infection symptoms.
Sepsis (25%):
Various bacteria with pathogenic or conditional pathogenicity can be the pathogen of sepsis. Due to the different ages, the underlying diseases of patients, the different routes of introduction and the different age groups, the bacteria causing sepsis are also different.
Endotoxin (25%):
Endotoxin is an important pathogenic factor. Endotoxin can kill experimental animals. It has capsular bacteria. Special type b can cause primary infection. No capsules cause secondary infection, which can be secondary to influenza. In patients with measles, whooping cough, and bronchitis, anti-capsular-specific antibodies can be produced after infection to obtain protective immunity.
Prevention
Haemophilus influenzae infection prevention
In the management of the source of infection, the patient should be completely cured, so that the pathogen is definitely negative, but it is difficult to manage for the majority of the nasopharyngeal carriers. There is also a lack of effective methods for cutting off the respiratory tract. Therefore, the main measure for prevention of this disease is the implementation of active immunization vaccination.
Complication
Haemophilus influenzae infection complications Complications appendicitis septic arthritis osteomyelitis epididymitis mastoiditis
Haemophilus influenzae can also cause other purulent infections:
1 appendicitis.
2 biliary infections.
3 septic arthritis.
4 paranasal sinusitis.
5 osteomyelitis.
6 epididymitis.
7 mastoiditis and so on.
Symptom
Haemophilus influenzae infection symptoms Common symptoms Sore throat abscess Skin soft tissue infection HIV infection Epiglottis mastocytosis bacteremia meningitis trauma empyema
Pneumonia
Adult patients are mostly patients with chronic respiratory diseases, manifested as bronchial pneumonia, segmental pneumonia, and even lobar pneumonia, half of the pleural involvement, but less common in patients with empyema, 80% caused by capsule type b bacteria However, some patients are caused by non-enveloped bacteria, and the prognosis depends on the patient's original health status, and the mortality rate can reach more than 30%.
2. Meningitis
More than 60% of purulent meningitis in infants and young children is caused by this strain. From the 1950s to the 1980s, the incidence of children under 5 years old increased by 6 times. In the past, the incidence rate of adults was low, about 1% to 3%, but in recent years, the incidence The rate is also rising, there have been reports of up to 20%, adults have more primary lesions, such as paranasal sinusitis, pneumonia, epiglottis, etc., especially prone to head trauma or cerebrospinal fluid leakage, pathogenic bacteria are mostly Type B bacteria, clinical manifestations, cerebrospinal fluid examination are similar to other purulent meningitis, the mortality rate of adults is 10% to 20%.
3. Epiglottis
Most of the patients are healthy and younger, fever, sore throat, due to severe local swelling can cause blockage of the respiratory tract, which is the main cause of death.
Examine
Examination of Haemophilus influenzae infection
1. Blood: The white blood cells can be in the normal range, and the severe cases can increase by more than 10×109/L, and the neutral can account for more than 80%.
2. Cerebrospinal fluid examination: Similar to other sputum-producing people, protein increases, sugar and chloride decrease, leukocytosis increases above 1000×106/L, and multinucleated cells account for the majority.
3. Pathogen examination
(1) direct examination of smear: sputum in patients with pneumonia, cerebrospinal fluid in patients with meningitis, and purulent secretions in purulent infections, all of which can be smear-stained. If Gram-negative bacilli are found to be helpful for diagnosis.
(2) Bacterial culture: Cerebrospinal fluid and urine culture can be used as a basis for diagnosis. Pharyngeal culture and sputum culture can not be excluded due to bacteria. It must be combined with clinical and other examinations. The chocolate medium used in the past is not sensitive enough. The slide agglutination test and the capsular expansion test determine the type of bacteria.
Diagnosis
Diagnosis and identification of Haemophilus influenzae infection
Diagnostic criteria
Clinical manifestation
Haemophilus influenzae can cause infections in multiple parts of the body. Local infections may include otitis media, sinusitis, mastoiditis, epiglottis and skin and soft tissue infections. Systemic infections may include pneumonia, meningitis, endocarditis, osteomyelitis. Suppurative osteoarthritis, genitourinary tract infections, etc., chronic respiratory infections should consider the possibility of Haemophilus parainfluenza infection.
Differential diagnosis
1, Coxsackie virus infection: the general incubation period of 1 to 3 days, upper respiratory tract infection, acute onset, runny nose, cough, sore throat, fever, general malaise. The typical symptoms are herpes angina, that is, herpes zoster in the nasopharynx, epiglottis, tongue and soft palate, mucosal redness, lymphoid follicular hyperplasia, exudation, tonsil enlargement, difficulty in swallowing, loss of appetite, generally requires serum You can identify it by examining it.
2, bacterial infection: the primary inflammation is characterized by local redness, swelling, heat, pain and dysfunction. More onset of illness. Often there are chills, high fever, and fever, which are mostly relaxation heat or intermittent heat. They can also be caused by heat retention, irregular heat and bimodal fever. The latter are caused by sepsis-negative bacilli sepsis.
