Epiglottitis is a rapidly progressive epiglottis infection leading to upper airway edema. This study aimed to detect the main causative agent, viral infection, by immunofluorescence antibody technique and PCR technique and bacterial infection detection by specific gene among young children suffering from epiglottitis. This study included 85 young children aged 10-15 years. The virus was identified on 85 blood samples using the CER test Human simplex virus Card test; the results revealed that 12 (14.1%) specimens were related to virus infection, and the sera of patients showed anti-IgM to HSV-1 antibodies. HSV-1 was detected in blood samples by qPCR technique. Eighty-five saliva samples were collected from young children suffering from epiglottitis. The samples were cultured for 18-24 hours at 37°C. They were then cultivated for 18-24 hours on various selective media at 37°C. The colony morphology, microscopically, and biochemical testing were used to identify Haemophilus influenzae as a first Identification. Out of 85 clinical specimens, 63 (74.1%) were positive culture, while 22 (25.9%) had no growth on culture media; out of 63 specimens, only 22 (34.9%) isolates belonged to Haemophilus influenzae by biochemical tests, while 41 (65.1%) related to other types of microorganisms. VITEK 2 was used to validate bacteria isolates from young children suffering from epiglottitis. The findings indicate that 22 (34.9%) isolates related to Haemophilus influenzae have been confirmed with an excellent ID message confidence level (94 to 99.8% likelihood percentage). This method is characterized by quick bacterial detection. DNA was taken from all suspected isolates previously identified as Haemophilus influenzae using the vitek2 technology, and traditional PCR was used to amplify specific hel gene for Haemophilus influenzae primers utilizing these DNA samples. After that, when compared to an allelic ladder, gel electrophoresis revealed that all 22 (100%) samples of Haemophilus influenzae produced 101 bp DNA fragments. For isolates previously identified as Haemophilus influenzae, molecular identification of the ompP gene was performed. The results showed that 12 (or 54.5 percent) of the 22 isolates tested positive for this virulence gene. When compared to an allelic ladder, the presence of (459 bp) bands indicated positive results. In addition, the bexA gene was molecularly detected in 22 Haemophilus influenzae isolates, showing that only 8 (36.3 percent) of the isolates had this gene. When compared to an allelic ladder, the presence of a (343 bp) band indicated positive results for bexA gene pathogenicity; in conclusion, HSV (1) and Hib were considered almost causative agents of epiglottitis in young children. |
- Woods CR. Epiglottitis (Supraglottitis). Clinical features and diagnosis. UpToDate; Waltham, MA: UpToDate. 2020.
- Swain SK, Nahak B, Debta P. Clinical characteristics and treatment of acute epiglottitis: A retrospective study of 28 cases. J Acute Dis. 2020;9(3):109.
- Parthasarathy V, Snyder B, Saddawi-Konefka R. A lot to choke on: case of adult epiglottitis with concurrent peritonsillar abscess in a patient with a sore throat. J Emerg Med. 2018;55(6):841-4.
- Tristram D. Laryngitis, Tracheitis, Epiglottitis, and Bronchiolitis. Introduction to Clinical Infectious Diseases: Springer; 2019. p. 75-85.
- Beltrami D, Guilcher P, Longchamp D, Crisinel PA. Meningococcal serogroup W135 epiglottitis in an adolescent patient. Case Rep. 2018;2018:bcr-2017.
- Slack M, Cripps A, Grimwood K, Mackenzie G, Ulanova M. Invasive Haemophilus influenzae infections after 3 decades of Hib protein conjugate vaccine use. Clin Microbiol Rev. 2021;34(3):e00028-21.
- Pittet LF, Curtis N. Postnatal exposure to herpes simplex virus: to treat or not to treat? Pediatr Infect Dis J. 2021;40(5):16-21.
- Kang HM, Kang JH. Effects of nasopharyngeal microbiota in respiratory infections and allergies. Clin Exp Pediatr. 2021;64(11):543.
- Reidenberg JS. Where does the air go? Anatomy and functions of the respiratory tract in the humpback whale (Megaptera novaeangliae). Madag Conserv Dev. 2018;13(1):91-100.
- Navazesh M. Methods for collecting saliva. Annals of the New York Academy of Sciences. 1993;694(1):72-7.
- Markoulatos P, Georgopoulou A, Siafakas N, Plakokefalos E, Tzanakaki G, Kourea-Kremastinou J. Laboratory diagnosis of common herpesvirus infections of the central nervous system by a multiplex PCR assay. J Clin Microbiol. 2001;39(12):4426-32.
- Maaroufi Y, De Bruyne J-M, Heymans C, Crokaert F. Real-time PCR for determining capsular serotypes of Haemophilus influenzae. J Clin Microbiol. 2007;45(7):2305-8.
- van Ketel RD, De Wever B, Van Alphen L. Detection of Haemophilus influenzae in cerebrospinal fluids by polymerase chain reaction DNA amplification. J Med Microbiol. 1990;33(4):271-6.
- Hendrixson DR, De La Morena ML, Stathopoulos C, St Geme III JW. Structural determinants of processing and secretion of the Haemophilus influenzae Hap protein. Mol Microbiol. 1997;26(3):505-18.
- Desloges I, Taylor JA, Leclerc JM, Brannon JR, Portt A, Spencer JD, et al. Identification and characterization of OmpT‐like proteases in uropathogenic Escherichia coli clinical isolates. Microbiologyopen. 2019;8(11):915.
- Cerqueira A, Byce S, Tsang RS, Jamieson FB, Kus JV, Ulanova M. Continuing surveillance of invasive Haemophilus influenzae disease in northwestern Ontario emphasizes the importance of serotype a and non-typeable strains as causes of serious disease: a Canadian Immunization Research Network (CIRN) Study. Can J Microbiol. 2019;65(11):805-13.
- Lu'ukia Ruidas M. Chapter IX. 7. Gastrointestinal Foreign Bodies.
- Kivekäs I, Rautiainen M. Epiglottitis, acute laryngitis, and croup. Infections of the ears, nose, throat, and sinuses. 2018:247-55.
- Dekker JP, Frank KM. Salmonella, Shigella, and yersinia. Clin Lab Med. 2015;35(2):225-46.
- Iskander M. Development and evaluation of a core genome MLST schema for Haemophilus influenza. 2017.
- Carloni I, Ricci S, Rubino C, Cobellis G, Rinaldelli G, Azzari C, et al. Necrotizing pneumonia among Italian children in the pneumococcal conjugate vaccine era. Pediatr Pulmonol. 2021;56(5):1127-35.
- Nanduri SA, Sutherland AR, Gordon LK, Santosham M. 23—Haemophilus influenzae Type Vaccines. Plotkin’s Vaccines, 7th ed; Plotkin, SA, Orenstein, WA, Offit, PA, Edwards, KM, Eds. 2017:301-18.
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