PMID- 6704799
OWN - NLM
STAT- MEDLINE
DCOM- 19840517
LR  - 20190829
IS  - 0317-1671 (Print)
IS  - 0317-1671 (Linking)
VI  - 11
IP  - 1
DP  - 1984 Feb
TI  - Fulminating haemophilus influenzae b meningitis.
PG  - 78-81
AB  - Haemophilus influenzae type b (HIb) is the most common cause of bacterial 
      meningitis in children with a mortality rate ranging from 1.6% to 14%. Most 
      patients have a 2-3 day history of symptoms prior to admission. A few have 
      fulminating disease with rapid neurological deterioration. Review of 191 cases of 
      HIb meningitis revealed a mortality rate of 2.1% but all who died had fulminating 
      meningitis (FM). Four of six patients with FM died. FM patients had symptoms for 
      less than 24 hours before rapid neurological deterioration with increased ICP, 
      seizures, coma and/or respiratory arrest. Review of 10 FM cases revealed that on 
      admission, 5 had hypotension, 3 had thrombocytopenia, and 8 had coma. Typical CSF 
      changes were seen in only 7. All fatal cases died within 24 hours. Brain swelling 
      and tonsillar herniation were found at autopsy. SDS-PAGE outer membrane protein 
      subtyping did not show one "killer strain". Animal and autopsy data suggest that 
      diminished CSF outflow and cerebral edema contribute to increased ICP. To improve 
      survival of FM patients, initial treatment must (1) decrease ICP below levels 
      impairing cerebral perfusion, (2) maintain adequate ventilation and blood 
      pressure, and include (3) LP when stable, (4) antibiotics, and (5) close 
      monitoring. Utilizing these principles, two FM patients survived without major 
      sequelae.
FAU - MacDonald, N E
AU  - MacDonald NE
FAU - Keene, D L
AU  - Keene DL
FAU - Mackenzie, A M
AU  - Mackenzie AM
FAU - Humphreys, P
AU  - Humphreys P
FAU - Jefferies, A L
AU  - Jefferies AL
FAU - Ivan, L P
AU  - Ivan LP
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Can J Neurol Sci
JT  - The Canadian journal of neurological sciences. Le journal canadien des sciences 
      neurologiques
JID - 0415227
SB  - IM
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Intracranial Pressure
MH  - Male
MH  - Meningitis, Haemophilus/blood/pathology/*physiopathology/therapy
EDAT- 1984/02/01 00:00
MHDA- 1984/02/01 00:01
CRDT- 1984/02/01 00:00
PHST- 1984/02/01 00:00 [pubmed]
PHST- 1984/02/01 00:01 [medline]
PHST- 1984/02/01 00:00 [entrez]
AID - 10.1017/s0317167100045376 [doi]
PST - ppublish
SO  - Can J Neurol Sci. 1984 Feb;11(1):78-81. doi: 10.1017/s0317167100045376.