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Haemophilus influenzae type B and its role in diseases of the head and neck.

Haemophilus influenzae is a common pathogen in infections of the head and neck. Although most mucosal infections (otitis media, sinusitis) are caused by non-encapsulated organisms, invasive disease (meningitis, periorbital cellulitis, epiglottis) is caused by type B encapsulated organisms. Bacteremia is common with H. influenzae type B infections and therapy with parenteral antibiotics is indicated. A vaccine against H. influenzae type B given at 18 months of age is now part of the routine childhood immunization schedule. Chemoprophylaxis with rifampin is recommended for at-risk contacts of patients with invasive type B disease. This review examines the bacteriology, pathogenesis, immunity, and disease manifestations of H. influenzae. Appropriate diagnostic methods, antimicrobial therapy, and recommended chemoprophylaxis and immunoprophylaxis are presented.