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J Pediatr Infect Dis 2011; 06(01): 041-044
DOI: 10.3233/JPI-2011-0283
Georg Thieme Verlag KG Stuttgart – New York

Severe complicated mastoiditis caused by nontypable Haemophilus influenzae

Ellen Bamberger
a   Department of Clinical Microbiology, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
b   Department of Pediatrics, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
,
Isaac Srugo
a   Department of Clinical Microbiology, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
b   Department of Pediatrics, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
,
Elena Segal
c   Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
,
Oded Glazer
b   Department of Pediatrics, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
,
Rabia Shihada
d   Department of Otolaryngology-Head and Neck Surgery, Bnai Zion Medical Center, Technion, Israel – Institute of Technology, Haifa, Israel
,
Alexander Brodsky
d   Department of Otolaryngology-Head and Neck Surgery, Bnai Zion Medical Center, Technion, Israel – Institute of Technology, Haifa, Israel
,
Jacob Braun
e   Department of Radiology, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
,
Michal Luntz
d   Department of Otolaryngology-Head and Neck Surgery, Bnai Zion Medical Center, Technion, Israel – Institute of Technology, Haifa, Israel
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Publication History

07 March 2010

28 July 2010

Publication Date:
28 July 2015 (online)

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Abstract

Non-typable Haemophilus influenzae (NTHi) is emerging as an important cause of invasive disease in immunized children. We describe a healthy, fully immunized 4-year old child who presented with bacteremia due to NTHi without overt acute otitis media (AOM), and subsequently developed severe mastoiditis complicated by sigmoid sinus thrombosis. Although, mastoiditis is typically regarded as a complication of AOM, those cases without antecedent AOM may represent an entirely different pathophysiological process with NTHi bacteremia seeding the mastoid. We present another example of the potential invasiveness of NTHi with a temporal sequence of events whereby NTHi bacteremia seeds the mastoid. This may represent novel sequelae of NTHi infection.

Keywords

Non-typable Haemophilus influenzae - mastoiditis - bacteremia