Early-Onset Haemophilus Sepsis in Newborn Infants: Clinical, Roentgenographic, and Pathologic Features

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Abstract
Nine infants with early-onset H. influenzae sepis were seen between Jan. 1973 and July 1977. Of the 5 isolated strains that were typed, only 1 was type B. All infants had respiratory distress, metabolic acidosis and large alveolar-arterial O2 tension difference gradients. Eight infants weighed less than 1500 gm and died; 1 infant weighed 1701 gm and survived. Roentgenograms in 6 of 8 showed hyaline membrane disease. Pulmonary pathologic specimens in 8 infants revealed hyaline membranes in 6 and polymorphonuclear leukocytes in the alveolar spaces in 4. In 2 infants, small gram-negative bacilli were noted within proteinaceous exudates in alveolar ducts. The route and time of infection in these infants with early-onset Haemophilus sepsis are unclear. The possibility that the infection occurs before birth and that these infants represent septically aborted prematures is suggested by the high incidence of prematurity in infants with early-onset Haemophilus sepsis and early detection of bacteremia in 3 infants.