Haemophilus influenzae type B (Hib) necrotizing soft tissue infection (NSTI) in a vaccinated 16-month-old Inuit boy: a case report.
Rachel Dorey, Alexander Morzycki, Darcy Scott et al.
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Case in brief
A 16-month-old Inuit boy developed a severe necrotizing soft tissue infection (NSTI) caused by Haemophilus influenzae type B (Hib) despite having received three doses of the Hib vaccine. Following a minor fall, he presented with fever and leg pain, initially treated for presumed acute otitis media. His condition worsened, leading to hospitalization, where he underwent surgical debridement and received targeted antimicrobial therapy. Blood and tissue cultures confirmed Hib, and he required extensive medical support and multiple surgeries.
What made this case unusual
This case highlights a rare occurrence of Hib NSTI in a vaccinated child, emphasizing the potential for vaccine failure and the need for vigilance in recognizing invasive Hib disease.
Diagnostic / clinical pearl
Clinicians should consider invasive Haemophilus influenzae type B infection in fully vaccinated children presenting with severe soft tissue infections, particularly in populations with known susceptibility.
Why it matters
This case underscores the importance of continued surveillance for Hib infections and the need for prompt surgical intervention and targeted therapy, especially in indigenous populations where vaccine failures may be more prevalent.