TAILIEUCHUNG - Chapter 139. Haemophilus Infections (Kỳ 3)

Nontypable H. influenzae Nontypable H. influenzae is a common cause of community-acquired bacterial pneumonia in adults. Nontypable H. influenzae pneumonia is especially common among patients with COPD or AIDS. The clinical features of H. influenzae pneumonia are similar to those of other types of bacterial pneumonia (including pneumococcal pneumonia). Patients present with fever, cough, and purulent sputum, usually of several days' duration. Chest radiography reveals alveolar infiltrates in a patchy or lobar distribution. Gram-stained sputum contains a predominance of small, pleomorphic, coccobacillary gram-negative bacteria. Exacerbations of COPD caused by nontypable H. influenzae are characterized by increased cough, sputum production, and shortness. | Chapter 139. Haemophilus Infections Kỳ 3 Nontypable H. influenzae Nontypable H. influenzae is a common cause of community-acquired bacterial pneumonia in adults. Nontypable H. influenzae pneumonia is especially common among patients with COPD or AIDS. The clinical features of H. influenzae pneumonia are similar to those of other types of bacterial pneumonia including pneumococcal pneumonia . Patients present with fever cough and purulent sputum usually of several days duration. Chest radiography reveals alveolar infiltrates in a patchy or lobar distribution. Gram-stained sputum contains a predominance of small pleomorphic coccobacillary gram-negative bacteria. Exacerbations of COPD caused by nontypable H. influenzae are characterized by increased cough sputum production and shortness of breath. Fever is low-grade and no infiltrates are evident on chest x-ray. Nontypable H. influenzae is one of the three most common causes of childhood otitis media the other two being Streptococcus pneumoniae and Moraxella catarrhalis Chap. 31 . Infants are febrile and irritable while older children report ear pain. Symptoms of viral upper respiratory infection often precede otitis media. The diagnosis is made by pneumatic otoscopy. An etiologic diagnosis although not routinely sought can be established by tympanocentesis and culture of middle-ear fluid. The increasing use of pneumococcal polysaccharide conjugate vaccines in infants is resulting in a relative increase in the proportion of otitis media cases that are caused by H. influenzae. Nontypable H. influenzae also causes puerperal sepsis and is an important cause of neonatal bacteremia. These nontypable strains which are closely related to H. haemolyticus tend to be of biotype IV and cause invasive disease after colonizing the female genital tract. Nontypable H. influenzae causes sinusitis Chap. 31 in adults and children. In addition the bacterium is a less common cause of various invasive infections that are reported .

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