Haemophilus influenzae Meningitis

Prior to the introduction of the Hib conjugate vaccine, H. influenzae type b was the most common cause of bacterial meningitis in the United States.5 Routine inoculation of pediatric patients against Hib since 1991 has reduced the incidence of invasive Hib disease (i.e., meningitis and sepsis) in children younger than 5 years of age by 99%,6 with mortality from Hib meningitis now less than 5%. The Hib vaccine is also recommended for patients undergoing splenectomy. Hib meningeal disease is often associated with a parameningeal focus such as a sinus or middle ear infection. Increases in ^-lactamase-mediated resistance have changed the empirical treatment of choice from ampicillin to third-generation cephalosporins (e.g., ceftriaxone and cefotaxime). Treatment should be continued for 7 days, after which no further maintenance therapy is required.

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