Case Report of International Journal of Case Reports
Supraglottitis secondary to Haemophilus influenzae serotype f infection: Case report and review of literature
Chelsea Jocelyn Kubinec and Marina Ulanova
Northern Ontario School of Medicine, Thunder Bay, Ontario
Introduction: Haemophilus influenzae is an important human pathogen capable of causing serious invasive disease. The H. influenzae serotype b (Hib) conjugate vaccine successfully reduced the incidence of invasive Hib disease globally, revealing the significance of other H. influenzae serotypes. The emergence of H. influenzae type f (Hif) invasive disease has been reported worldwide.
Case report: We identified a case of supraglottitis secondary to Hif in a 57-year-old female from northwestern Ontario without significant predisposing conditions. We describe the clinical presentation, disease progression, and outcome. The case is discussed in the context of current epidemiology of invasive Hif disease.
Conclusion: This report emphasizes the severity of Hif invasive disease and the need for continued surveillance at the international level. We call for the development of health promotion strategies and the consideration of a vaccine against this organism.
Keywords: Haemophilus influenzae; Haemophilus influenzae type f; invasive disease; epiglottitis; supraglottitis
How to cite this article:
Chelsea Jocelyn Kubinec and Marina Ulanova. Supraglottitis secondary to Haemophilus influenzae serotype f infection: Case report and review of literature. International Journal of Case Reports, 2020 4:113. DOI: 10.28933/IJCR-2019-12-1105
1. K. J. Ryan, Ed., “Haemophilus and Bordetella,” in Sherris Medical Microbiology, 7th ed., New York, NY: McGraw-Hill Education, 2017.
2. F. J. Cooke and M. P. E. Slack, “Gram-Negative Coccobacilli,” in Infectious Diseases, 4th ed., Philadelphia, PA, 2017.
3. M. Pittman, “Variation and type specificity in the bacterial species Hemophilus influenzae,” J. Exp. Med., vol. 53, no. 4, pp. 471–492, 1931, doi: 10.1084/jem.53.4.471.
4. A. Zwahlen, J. S. Kroll, L. G. Rubin, and E. R. Moxon, “The molecular basis of pathogenicity in Haemophilus influenzae: Comparative virulence of genetically-related capsular transformants and correlation with changes at the capsulation locus cap,” Microb. Pathog., vol. 7, no. 3, pp. 225–235, 1989, doi: 10.1016/0882-4010(89)90058-2.
5. H. Peltola, “Worldwide Haemophilus inﬂuenzae type b disease at the beginning of the 21st century: Global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates,” Clin Microbiol Rev, vol. 13, p. 16, 2000, doi: 10.1128/cmr.13.2.302-317.2000.
6. Public Health Agency of Canada, “Haemophilus influenzae disease,” 16-Sep-2014. Available: https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/haemophilus-influenzae-disease/health-professionals.html.
7. Government of Canada and Public Health Agency of Canada, “Reported cases from 1991 to 2016 in Canada – Notifiable diseases on-line,” 25-Nov-2018. Available:
8. H. J. Adam, S. E. Richardson, F. B. Jamieson, P. Rawte, D. E. Low, and D. N. Fisman, “Changing epidemiology of invasive Haemophilus influenzae in Ontario, Canada: Evidence for herd effects and strain replacement due to Hib vaccination,” Vaccine, vol. 28, no. 24, pp. 4073–4078, 2010, doi: 10.1016/j.vaccine.2010.03.075.
9. S. Desai et al., “The epidemiology of invasive Haemophilus influenzae Non-serotype b disease in Ontario, Canada from 2004 to 2013,” PloS One, vol. 10, no. 11, p. e0142179, 2015, doi: 10.1371/journal.pone.0142179.
10. G. Urwin, J. A. Krohn, K. D. Robinson, J. D. Wenger, and M. M. Farley, “Invasive disease due to Haemophilus influenzae serotype f: Clinical and epidemiologic characteristics in the H. influenzae serotype b vaccine era,” Clin. Infect. Dis., vol. 22, no. 6, pp. 1069–1076, 1996, doi: 10.1093/clinids/22.6.1069.
11. S. Ladhani, M. P. E. Slack, P. T. Heath, A. von Gottberg, M. Chandra, and M. E. Ramsay, “Invasive Haemophilus influenzae disease, Europe, 1996–2006,” Emerg. Infect. Dis., vol. 16, no. 3, pp. 455–463, 2010, doi: 10.3201/eid1603.090290.
12. P. T. Heath et al., “Non-type b Haemophilus influenzae disease: Clinical and epidemiologic characteristics in the Haemophilus influenzae type b vaccine era,” Pediatr. Infect. Dis. J., vol. 20, no. 3, pp. 300–305, 2001, doi: 0.1097/00006454-200103000-00016.
13. A. McConnell et al., “Invasive infections caused by Haemophilus influenzae serotypes in twelve Canadian IMPACT centers, 1996–2001,” Pediatr. Infect. Dis. J., vol. 26, no. 11, pp. 1025–1031, 2007, doi: 10.1097/INF.0b013e31812f4f5b.
14. M. Giufrè, R. Cardines, M. G. Caporali, M. Accogli, F. D’Ancona, and M. Cerquetti, “Ten years of Hib vaccination in Italy: Prevalence of non-encapsulated Haemophilus influenzae among invasive isolates and the possible impact on antibiotic resistance,” Vaccine, vol. 29, no. 22, pp. 3857–3862, 2011, doi: 10.1016/j.vaccine.2011.03.059.
15. R. C. Zanella, S. Bokermann, A. L. S. S. Andrade, B. Flannery, and M. C. de C. Brandileone, “Changes in serotype distribution of Haemophilus influenzae meningitis isolates identified through laboratory-based surveillance following routine childhood vaccination against H. influenzae type b in Brazil,” Vaccine, vol. 29, no. 48, pp. 8937–8942, 2011, doi: 10.1016/j.vaccine.2011.09.053.
16. N. D. Hartman, “Neck and Upper Airway,” in Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8th ed., J. E. Tintinalli, J. S. Stapczynski, O. J. Ma, D. M. Yealy, G. D. Meckler, and D. M. Cline, Eds. New York, NY: McGraw-Hill Education, 2016.
17. A. Eskander et al., “Disorders of the Head and Neck,” in Schwartz’s Principles of Surgery, 11th ed., F. C. Brunicardi, D. K. Andersen, T. R. Billiar, D. L. Dunn, L. S. Kao, J. G. Hunter, J. B. Matthews, and R. E. Pollock, Eds. New York, NY: McGraw-Hill Education, 2019.
18. C. Won, G. Michaud, and M. H. Kryger, “Upper Airway Obstruction in Adults,” in Fishman’s Pulmonary Diseases and Disorders, 5th ed., M. A. Grippi, J. A. Elias, J. A. Fishman, R. M. Kotloff, A. I. Pack, R. M. Senior, and M. D. Siegel, Eds. New York, NY: McGraw-Hill Education, 2015.
19. F. Glynn and J. E. Fenton, “Diagnosis and management of supraglottitis (epiglottitis),” Curr. Infect. Dis. Rep., vol. 10, no. 3, pp. 200–204, 2008, doi: 10.1007/s11908-008-0033-8.
20. R. K. Shah and C. Stocks, “Epiglottitis in the United States: National trends, variances, prognosis, and management,” The Laryngoscope, vol. 120, no. 6, pp. 1256–1262, 2010, doi: 10.1002/lary.20921.
21. B. Briem, O. Thorvardsson, and H. Petersen, “Acute epiglottitis in Iceland 1983-2005,” Auris. Nasus. Larynx, vol. 36, no. 1, pp. 46–52, 2009, doi: 10.1016/j.anl.2008.03.012.
22. M. F. Mayo-Smith, J. W. Spinale, F. J. Schiffman, C. J. Donskey, M. Yukawa, and R. H. Li, “Acute epiglottitis: An 18-year experience in Rhode Island,” Chest, vol. 108, no. 6, pp. 1640–1647, 1995, doi: 10.1378/chest.108.6.1640.
23. E. Guardiani, M. Bliss, and E. Harley, “Supraglottitis in the era following widespread immunization against Haemophilus influenzae type B: Evolving principles in diagnosis and management,” The Laryngoscope, vol. 120, no. 11, pp. 2183–2188, 2010, doi: 10.1002/lary.21083.
24. A. V. Navaratnam, M. E. Smith, A. Majeed, and D. J. McFerran, “Adult supraglottitis: A potential airway emergency that can present in primary care,” Br. J. Gen. Pract., vol. 65, no. 631, pp. 99–100, 2015, doi: 10.3399/bjgp15X683653.
25. M. A. Rubin, L. C. Ford, and R. Gonzales, “Sore Throat, Earache, and Upper Respiratory Symptoms,” in Harrison’s Principles of Internal Medicine, 20th ed., J. L. Jameson, A. S. Fauci, D. L. Kasper, S. L. Hauser, D. L. Longo, and J. Loscalzo, Eds. New York, NY: McGraw-Hill Education, 2018.
26. L. N. Slater, J. Guarnaccia, S. Makintubee, and G. R. Istre, “Bacteremic disease due to Haemophilus influenzae capsular type f in adults: Report of five cases and review,” Rev. Infect. Dis., vol. 12, no. 4, pp. 628–635, 1990, doi: 10.1093/clinids/12.4.628.
27. B. Bruun, B. Gahrn-Hansen, H. Westh, and M. Kilian, “Clonal relationship of recent invasive Haemophilus influenzae serotype f isolates from Denmark and the United States,” J. Med. Microbiol., vol. 53, no. Pt 11, pp. 1161–1165, 2004, doi: 10.1099/jmm.0.45749-0.
28. V. M. Brown, S. Madden, L. Kelly, F. B. Jamieson, R. S. W. Tsang, and M. Ulanova, “Invasive Haemophilus influenzae disease caused by non-type b strains in Northwestern Ontario, Canada, 2002–2008,” Clin. Infect. Dis., vol. 49, no. 8, pp. 1240–1243, 2009, doi: 10.1086/605671.
29. P. C. Hébert, Y. Ducic, D. M. Boisvert, and A. G. Lamothe, “Adult epiglottitis in a Canadian setting,” The Laryngoscope, vol. 108, no. 1, pp. 64–69, 1998, doi: 10.1097/00005537-199801000-00012.
30. S. Suzuki, H. Yasunaga, H. Matsui, K. Fushimi, and T. Yamasoba, “Factors associated with severe epiglottitis in adults: Analysis of a Japanese inpatient database,” The Laryngoscope, vol. 125, no. 9, pp. 2072–2078, 2015, doi: 10.1002/lary.25114.
31. P. J. Yoon, M. A. Scholes, and N. R. Friedman, “Ear, Nose, & Throat,” in Current Diagnosis & Treatment: Pediatrics, 24th ed., Jr. Hay William W., M. J. Levin, R. R. Deterding, and M. J. Abzug, Eds. New York, NY: McGraw-Hill Education, 2018.
32. E. C. Jauch and J. W. Howell, “Oral Conditions,” in The Atlas of Emergency Medicine, 4th ed., K. J. Knoop, L. B. Stack, A. B. Storrow, and R. J. Thurman, Eds. New York, NY: McGraw-Hill Education, 2016.
33. P. M. Weinberger and D. J. Terris, “Otolaryngology: Head & Neck Surgery,” in Current Diagnosis & Treatment: Surgery, 14th ed., G. M. Doherty, Ed. New York, NY: McGraw-Hill Education, 2015.
34. A. W. Chow, “Life-Threatening Infections of the Head, Neck, and Upper Respiratory Tract,” in Principles of Critical Care, 4th ed., J. B. Hall, G. A. Schmidt, and J. P. Kress, Eds. New York, NY: McGraw-Hill Education, 2015.
35. T. C. Stallard, “Emergency Disorders of the Ear, Nose, Sinuses, Oropharynx, & Mouth,” in Current Diagnosis & Treatment: Emergency Medicine, 8th ed., C. K. Stone and R. L. Humphries, Eds. New York, NY: McGraw-Hill Education, 2017.
36. R. Candamourty, S. Venkatachalam, M. R. R. Babu, and G. S. Kumar, “Ludwig’s Angina – An emergency: A case report with literature review,” J. Nat. Sci. Biol. Med., vol. 3, no. 2, pp. 206–208, 2012, doi: 10.4103/0976-9668.101932.
37. V. Brown, “The incidence of invasive Haemophilus influenzae disease in Northwestern Ontario,” Master of Public Health, Lakehead University, Thunder Bay, Ontario, Canada, 2009.
38. Y. Zhang and M. Engelhart, “Type f Haemophilus influenzae cellulitis in the upper extremities of an immunocompetent adult,” Clin. Exp. Rheumatol., vol. 27, no. 1, p. 163, 2009.
39. B. L. Wasilauskas and K. D. Hampton, “Adult meningitis caused by Hemophilus influenzae serotype f, biotype I,” Arch. Pathol. Lab. Med., vol. 110, no. 5, pp. 437–438, 1986.
40. S. Sakamoto and N. Sakamoto, “Bacterial meningitis caused by β-lactamase non-producing ampicillin-resistant Haemophilus influenzae type f in an immunocompetent woman,” Intern. Med. Tokyo Jpn., vol. 58, no. 2, pp. 307–310, 2019, doi: 10.2169/internalmedicine.0597-17.
41. M. McGuinn and K. Kanaparthy, “Haemophilus influenzae serotype f septic arthritis, meningitis, and bacteremia in a healthy adult: An emerging pathogen?” Infect. Dis. Clin. Pract., vol. 16, no. 4, pp. 264–265, 2008, doi: 10.1097/IPC.0b013e318162a96e.
42. B. Trollfors, B. Claesson, T. Lagergård, and T. Sandberg, “Incidence, predisposing factors and manifestations of invasive Haemophilus influenzae infections in adults,” Eur. J. Clin. Microbiol., vol. 3, no. 3, pp. 180–184, 1984, doi: 10.1007/BF02014874.
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