Article in Japanese

Haemophilus influenzae type b meningitis synchronously developed in identical male twins

Toshihiko MORI, Masahiro SHIRAISHI, Emiko HOSHINO, Yuki KUROIWA

Haemophilus influenzae type b (Hib) is the leading cause of bacterial meningitis among children younger than 5 years of age. More than 110 countries that included Hib conjugate vaccines in their routine vaccination programs have seen a dramatic decrease in the incidence of Hib infections. This study reports on identical twins with meningitis due to Hib. A previously healthy 1-year-old boy accompanied by his younger brother, was admitted to the hospital presenting fever, vomiting and convulsions. Hib was isolated from his cerebrospinal fluid (CSF) and he was diagnosed as having purulent meningitis. The younger brother did not receive a preventative Hib vaccine or antimicrobial medication after the elder brother was diagnosed, and the younger child developed similar symptoms eight days later. Although the strain of Hib isolated from CSF of the elder brother was susceptive to ceftriaxone and panipenem/betamipron, the clinical efficacy was insufficient. Both children were treated with ceftriaxone and meropenem intravenously, and they both made an uneventful recovery. Although effective vaccination programs will reduce the cases of Hib meningitis: when the disease does occur, early diagnosis and treatment is necessary in preventing severe sequelae. All infants, including those born prematurely, should receive a primary series of Hib vaccine beginning at 2 months of age.

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Department of Pediatrics, NTT East Sapporo Hospital

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Received	March 18, 2013
Accepted	July 16, 2013

25 (3)：297─302,2013