From Altered Sensorium to Bacterial Meningitis: A Case of Haemophilus influenzae

ABSTRACT

Haemophilus influenzae is a well-known cause of bacterial meningitis, especially in individuals who are at risk such as unvaccinated individuals, immunocompromised and the elderly. The present case report discusses a patient who showed altered sensorium as the main clinical presentation, which can be quite challenging to diagnose because of its wide range of differential diagnoses. The patient showed a gradually worsening state of consciousness with a fever, nuchal rigidity and photophobia, which required immediate neurological consultation. Cerebrospinal fluid examination has shown an increase in the number of white cells with neutrophil dominance, a significant increase in the amount of protein and a reduction in the level of glucose, which is characteristic of bacterial meningitis. Haemophilus influenzae was identified as the pathogen by Gram staining and culture. Immediately, empirical antibiotic therapy was introduced and later customised depending on the sensitivity findings, and it resulted in a clinical improvement. The neuroimaging was done to rule out complications like cerebral oedema and subdural empyema. The case highlights the seriousness of the importance of the early identification of altered sensorium as a possible precursor of bacterial meningitis, despite the absence of the classic signs of meningitis at the first presentation. It also points out the ultimate clinical relevance of Haemophilus influenzae as a meningeal pathogen in the absence of the pediatric age group. Early lumbar puncture, proper antimicrobial treatment, and close observation are still the pillars of the therapy to minimise the morbidity and mortality rates of this life-threatening disease.

Keywords: Altered sensorium, Bacterial meningitis, Haemophilus influenzae, Cerebrospinal fluid, Nuchal rigidity, Lumbar puncture, Antimicrobial therapy, Neutrophilic pleocytosis, Neurological deterioration, Meningeal pathogen.

How to cite this article: Shaji A, Fareedh R, Umashankar R, Ramineni S, Aishwarya Lakshmi MV, Sheik Arshad Ali, Shobana S. From Altered Sensorium to Bacterial Meningitis: A Case of Haemophilus influenzae. Int J Drug Deliv Technol. 2026;16(4):504-511. DOI: 10.25258/ijddt.16.4.51

Source of support: Nil.

Conflict of interest: The authors declare no conflict of interest.