Academic literature on the topic 'Acute otitis media Haemophilus influenzae'

Haemophilus influenzae is a Gram-negative bacillus that is an exclusively human pathogen and commensal. There are six capsular serotypes (a–f), of which type b (Hib) is a major cause of childhood infectious disease. Transmission occurs by close bodily contact, the main source being other children. Carriage of the organism may be followed by disease in susceptible individuals. In infants, Hib causes symptoms ranging from a mild non-specific febrile illness (occult bacteraemia) to fully blown sepsis with meningitis, epiglottitis, pneumonia, septic arthritis, or cellulitis. Non-typeable H. influenzae are common nasopharyngeal commensals and cause otitis media and conjunctivitis in children. In adults, non-typeable H. influenzae cause exacerbations of chronic bronchitis, sinusitis, and pneumonia. Other Haemophilus species, including H. parainfluenzae, are common commensals and rare causes of infective endocarditis and other sepsis.

Pharyngitis is common with incidence peaking from autumn to spring. Respiratory viruses are most commonly implicated, and are generally self-limiting conditions not requiring diagnostic workup or treatment. Bacterial pharyngitis is less common, is spread by droplets or direct transmission, and Streptococcus pyogenes (Group A strep, or GAS) is the most frequent cause. Haemophilus influenzae, Mycoplasma pneumoniae, and Neisseria gonorrhoeae are less frequent causes. Rapid antigen detection tests make the point-of-care assessment of GAS pharyngitis possible, although a negative test does not exclude infection. No method can distinguish oropharyngeal colonization from actual infection, but culture can obtain antibiotic susceptibility testing. Suspicion of infection with Neisseria gonorrhoeae, Bordetella pertussis, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Corynebacterium diptheriae should be communicated to the laboratory so that the appropriate culture media is utilized. The Centor criteria provide a clinical predictive score that can give the likelihood a sore throat is due to a bacterial infection with the following: the presence of tonsillar exudate, tender anterior cervical adenopathy, fever over 38°C, and absence of cough. If three or four of these criteria are met, the positive predictive value is 40% to 60%. The absence of three or four of the Centor criteria has a relatively high negative predictive value of 80%, and may be use to evaluate whether antibiotics can be withheld or deferred. Oral penicillin or macrolide are used to treat streptococcal pharyngitis. Treatment may reduce severity, duration, transmission, and risk of post-infectious sequelae like rheumatic heart disease and post-streptococcal glomerulonephritis. Other complications include scarlet fever, streptococcal toxic shock syndrome, and quinsy. Otitis media, is frequent in the young children, possibly due to a short and horizontal Eustachian tube. Purulent material buils up leading to a bulging, red tympanic membrane which may rupture and discharge. Intense local pain and fevers may occur. Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae are frequently implicated. Frequently there are no sequelae, although complications include hearing impairment, and less common are mastoiditis, bacteraemia, and meningitis. Diagnosis is clinical based on presentation and otoscopic examination. Microbiological diagnosis is possible through culture of exuate on swab or following tympanocentesis.