Non-typeable Haemophilus influenza ventriculitis, a case report and literature review.

Introduction: and importance: Haemophilus influenza severe presentations have decreased dramatically after the Hib vaccination was introduced. However, due to the emergence of Multi-drug resistance organisms, severe presentations like meningitis and ventriculitis may occur.

Case Presentation: Here, we have described a rarely reported case of non-typeable Haemophilus influenza ventriculitis in a previously healthy patient. MRI of the head with contrast was suggestive of tiny foci of diffusion restriction in occipital horns of bilateral ventricles with minimal intraventricular pus formation. The diagnosis was confirmed based on blood culture results and MRI findings as the patient refused to have a lumbar puncture procedure for CSF analysis. The patient was treated with intravenous antibiotics and showed a good response.

Clinical Discussion: In the post-HiB immunization era, we have seen a decline in invasive diseases caused by Type B Haemophilus influenza. However, non-typeable Haemophilus influenzae is now on the rise. Central nervous system infection due to non-typable Haemophilus influenza is infrequent as this organism is predominantly a respiratory mucosal pathogen resulting in acute and chronic respiratory tract infections. Multi-drug resistance of non-typeable Haemophilus influenzae is also becoming a cause of concern.

Conclusion: Ventriculitis secondary to non-typeable beta-lactamase non-producing, ampicillin-resistant (BLNAR) Haemophilus influenza is rare, and more such cases need to be reported within the adult population to avoid under-recognition.