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Archivos de Pediatría del Uruguay

Print version ISSN 0004-0584On-line version ISSN 1688-1249

Abstract

VOMERO, Alejandra; VAZQUEZ, Ana Inés; DELFINO, Marcos  and  PIREZ, Catalina. A clinical case of face and neck cellulite due to type b Haemophilus influenzae. Arch. Pediatr. Urug. [online]. 2019, vol.90, n.1, pp.12-17. ISSN 0004-0584.  http://dx.doi.org/10.31134/ap.90.1.3.

Haemophilus influenzae type b is a globally spread Gram-negative encapsulated bacterium. It is responsible for several invasive disease clinical manifestations, such as meningitis, epiglottitis, bacteremia, septic arthritis, cellulitis, osteomyelitis and pericarditis. These are immuno-preventable diseases.

Facial cellulitis caused by Haemophilus influenzae type b is a potentially serious invasive infection predominantly affecting children under 2 years of age, since this an immunologically susceptible population. There are characteristic clinical elements, though not pathognomonic, that arise suspicion of this infection.

We present a clinical case of an 8-month old infant, immunized with only one dose of BCG vaccine (calmetization), who arrived at the emergency ward with extended swelling of the face and was admitted to the intermediate care unit with a clinical diagnosis of cellulitis. Due to the rapid extension of the infectious process, he had to be transferred to the intensive care unit. Clinical tests to assess the infection and a CT scan were performed, which confirmed the process and the existence of a collection. We started empiric antibiotic therapy and surgical drainage and obtained a good clinical evolution. Haemophilus influenzae type b was isolated in the blood culture. We emphasize the importance of vaccination as well as of an active epidemiological surveillance.

Keywords : Haemophilus influenzae tipo b; Bacteremia; Cellulitis; Face; Neck.

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