A one-year-old infant who had not received routine childhood vaccinations was hospitalized last week at Shaare Zedek Medical Center in life-threatening condition with epiglottitis, a rare inflammation of the epiglottis that can block the airway. Doctors said the child had contracted Haemophilus influenzae type B, a bacterium covered by the routine vaccine schedule and an uncommon cause of this disease. After rapid diagnosis and intensive treatment, the baby’s condition stabilized and he was moved out of pediatric intensive care to the children’s ward.
The case initially looked like a swallowed foreign object, based on the father’s account to Magen David Adom. Doctors first used a special endoscopic camera to look for and remove an object, but found no evidence that anything had been swallowed. They then re-interviewed the father, learned the infant had not been vaccinated, and, together with the severe swelling and edema threatening to close the airway, suspected epiglottitis. Lab tests later confirmed infection with Haemophilus influenzae type B.
Because the swelling was so extreme that it blocked the trachea, anesthesiologists Dr. Mordechai Sherki and Dr. Shmuel Bshmut used an unusually tiny tube, normally used to ventilate premature newborns, to intubate the child and prevent suffocation. The treatment involved a multidisciplinary team, including pediatric, ENT, anesthesia and nursing staff, under the pediatric intensive care unit led by Dr. Jacques Brown, and later the children’s ward led by Prof. Orly Magd.
Dr. Efrat Blankinstein, a pediatric resident who helped treat the baby, said: "The baby was only minutes away from death." She added that the event had not occurred at Shaare Zedek for decades, that it had been a theoretical emergency until now, and that vaccination would have prevented it. Dr. Shani Mesner Firaizen, another resident who treated the infant, said the infection attacks the cartilage tissue that normally keeps food out of the trachea, causing rapid swelling that can suddenly obstruct breathing.
