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Haemophilus Infections / Necrotizing Soft Tissue Infection / Soft Tissue Infections · case report
International Journal of Circumpolar Health · July 14, 2026
Early or partial results. Treat as a signal, not a conclusion.
This case documents severe necrotizing soft tissue infection caused by Haemophilus influenzae type B in a 16-month-old Inuit child who had received 3 doses of Hib vaccine, illustrating vaccine failure before the 18-month booster dose. The patient required emergent surgical debridement, intensive care support including mechanical ventilation and inotropes, multiple debridements, and skin grafting, with blood and tissue cultures confirming monomicrobial Hib infection.
Case report. 16-month-old Inuit boy who had received 3 doses of Hib vaccine, presenting after minor thigh trauma. n = 1.
16-month-old with 3 Hib vaccine doses developed monomicrobial Hib NSTI following minor thigh trauma Laboratory findings included C-reactive protein >90 mg/L and white blood cell count 13.6 ×10⁹/L Patient required mechanical ventilation, inotropic support, and multiple surgical debridements before skin grafting
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should maintain suspicion for invasive Hib disease including NSTI even in vaccinated children, particularly before the 18-month booster when immunity may wane. Prompt recognition, emergent surgical debridement, broad-spectrum antimicrobials, and evaluation for underlying immunodeficiency are warranted in such cases.
Single case report documenting Hib NSTI vaccine failure in a partially vaccinated infant; provides clinical detail but no comparative evidence.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should maintain suspicion for invasive Hib disease including NSTI even in vaccinated children, particularly before the 18-month booster when immunity may wane. Prompt recognition, emergent surgical debridement, broad-spectrum antimicrobials, and evaluation for underlying immunodeficiency are warranted in such cases.
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Necrotizing soft tissue infection (NSTI) caused by Haemophilus influenzae type B (Hib) is rare and life-threatening. We report severe monomicrobial Hib NSTI in a 16-month-old Inuit child who had received 3 doses of the Hib vaccine, highlighting vaccine failure and host susceptibility. The child sustained a minor fall to the left thigh without skin breakdown and developed fever the same day, initially treated with amoxicillin for presumed acute otitis media. He re-presented with persistent fever, progressive leg pain, swelling, ecchymosis, and refusal to weight-bear, prompting air transfer to the regional hospital and the initiation of ceftriaxone. Investigations showed C-reactive protein >90 mg/L, a white blood cell count of 13.6 ×10⁹/L, normal creatine kinase, and unremarkable radiographs. Owing to concern for necrotizing infection, the patient was transferred to a tertiary pediatric intensive care unit. Antimicrobials were escalated to piperacillin-tazobactam, vancomycin, and clindamycin, and intravenous immunoglobulin was administered. Emergent surgical debridement demonstrated extensive dermal and subcutaneous necrosis with preserved fascia and muscle. Blood and tissue cultures grew Hib. He required mechanical ventilation, inotropic support, and multiple additional debridements prior to skin grafting. Household contacts received chemoprophylaxis. Immunologic evaluation was unremarkable; genetic testing was non-diagnostic. NSTI requires prompt recognition, surgical debridement, and targeted antimicrobial therapy. While most cases are due to group A Streptococcus or polymicrobial infections, Hib is rare, with few pediatric cases reported. Vaccine failures occur, particularly before the 18-month booster, reflecting waning immunity. Indigenous populations remain disproportionately affected. Invasive Hib disease despite vaccination warrants evaluation for underlying immunodeficiency. Invasive Hib infection should be considered even in fully vaccinated children. Continued surveillance, prompt surgical management, public health response and investigations of host susceptibility remain essential.
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