Adult Nontypeable Haemophilus influenzae Meningitis: A Case Report in the Post-Hib Era
TL;DR
A 47-year-old woman with several days of progressive headache, fever, and evolving neck pain after repeated evaluations with unrevealing acute neuroimaging is described, highlighting a less fulminant adult presentation and providing a focused review of modern strain epidemiology, pathogen-directed treatment, public-health implications, and a stepwise evaluation for anatomic or immunologic vulnerability after adult H. influenzae meningitis.
Abstract
Abstract: Adult Haemophilus influenzae meningitis is uncommon in the post-Hib vaccine era and frequently occurs in association with an ENT source, cerebrospinal fluid (CSF) leakage, or immune compromise. We describe a 47-year-old woman with several days of progressive headache, fever, and evolving neck pain after repeated evaluations with unrevealing acute neuroimaging. CSF demonstrated neutrophilic pleocytosis, hypoglycorrhachia, and elevated protein. CSF culture and a multiplex meningitis/encephalitis PCR panel both identified H. influenzae; the isolate was nontypeable and beta-lactamase negative. She was treated with ceftriaxone 2 g intravenously every 12 h for 14 days and returned to her clinical baseline. This case highlights a less fulminant adult presentation and provides a focused review of modern strain epidemiology, pathogen-directed treatment, public-health implications, and a stepwise evaluation for anatomic or immunologic vulnerability after adult H. influenzae meningitis.