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{
    "pk": 19226,
    "title": "Haemophilus influenzae Sepsis and Placental Abruption in an Unvaccinated Immigrant",
    "subtitle": null,
    "abstract": "Background: Haemophilus influenzae infections have declined dramatically in the United States sinceimplementation of the conjugate vaccine. However, in countries where widespread immunization is notroutine, H influenzae remains a significant cause of morbidity and mortality. We report a case of apreviously unvaccinated immigrant with confirmed H influenzae sepsis and placental abruption leadingto spontaneous abortion.\nObjectives: To alert emergency medicine practitioners that H influenzae should be recognized as amaternal, fetal, and neonatal pathogen. Clinicians should consider this diagnosis in immigrants presentingwith uncertain vaccination history, as H influenzae can cause significant morbidity and mortality.\nCase Presentation: A 36-year-old female was referred to our emergency department (ED) with lowerabdominal pain with some vaginal spotting. The patient had an initial visit with normal laboratoryinvestigations and normal imaging results, with complete resolution of symptoms. The patient returned tothe ED with sudden onset of vaginal bleeding and abdominal pain. She presented at this time with sepsis,which progressed to septic shock, causing placental abruption and ultimately, spontaneous abortion. Thepatient was treated with pressors and antibiotics and was admitted to the medical intensive care unitwhere she received ampicillin, gentamycin, and clindamycin for suspected chorioamnionitis. The patient’sblood cultures came back positive after 1 day for H influenzae. The patient did well and was dischargedfrom the hospital 4 days later.\nConclusion: Haemophilus influenzae should be recognized as a neonatal and maternal pathogen.Clinicians should consider this diagnosis in immigrants presenting with uncertain vaccination history,especially in pregnant females, as H influenzae can cause significant morbidity and mortality. [West JEmerg Med. 2012;13(1):133–135.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "case report"
        },
        {
            "word": "H. influenzae"
        },
        {
            "word": "sepsis"
        },
        {
            "word": "Placental Abruption"
        },
        {
            "word": "Unvaccinated Immigrant"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "Obstetrics and Gynecology"
        }
    ],
    "section": "Infectious Disease",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4313m32x",
    "frozenauthors": [
        {
            "first_name": "Paul",
            "middle_name": "A",
            "last_name": "Calner",
            "name_suffix": "",
            "institution": "Boston Medical Center, Department of Emergency Medicine, Boston,\nMassachusetts",
            "department": "None"
        },
        {
            "first_name": "Megan",
            "middle_name": "L",
            "last_name": "Salinas",
            "name_suffix": "",
            "institution": "Boston Medical Center, Department of Emergency Medicine, Boston,\nMassachusetts",
            "department": "None"
        },
        {
            "first_name": "Alaina",
            "middle_name": "",
            "last_name": "Steck",
            "name_suffix": "",
            "institution": "Boston Medical Center, Department of Emergency Medicine, Boston,\nMassachusetts",
            "department": "None"
        },
        {
            "first_name": "Elissa",
            "middle_name": "",
            "last_name": "Schechter-Perkins",
            "name_suffix": "",
            "institution": "Boston University, School of Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2011-05-01T15:54:59Z",
    "date_accepted": "2011-05-01T15:54:59Z",
    "date_published": "2012-02-24T22:05:07Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/19226/galley/9517/download/"
        }
    ]
}