Report of Haemophilus Influenzae serotype a intracranial infections in older children.

Introduction: Haemophilus influenzae (Hi) is subdivided into typeable (a-f) and non-typeable groups. Hi serotype b (Hib) has historically been one of the important pathogens responsible for invasive infection. However, after widespread Hib vaccination, the emergence of other Hi serotypes, specifically Hi serotype a (Hia), was noted during the last few decades, mostly in children younger than 5 years of age. Case presentation: We present two cases of severe intracranial infections with detected Hia in patients > 5 years of age within a short time frame and within the same geographic area. Conclusion: Epidemiological studies and surveillance on Hia-related illnesses in all age groups worldwide are needed to better understand the clinical and epidemiological characteristics of Hia. This can establish a platform to develop a candidate vaccine against Hia that might protect children of all ages.

Neuroimaging in Tick Paralysis: Looking Outside the Box.

Tick paralysis is a rare but potentially deadly form of muscle paralysis caused by a neurotoxin transmitted through the saliva of gravid, engorged female ticks of various species. Often, there is an initial misdiagnosis or delay in diagnosis due to the rarity of the diagnosis, the obscure location of the tick, and the disease's clinical similarity to Guillain-Barre syndrome. We report the case of a 4-year-old girl with tick paralysis in whom the tick was not found until 2 days after hospital admission. Upon the review of the imaging, it was discovered that the tick was visible on the MRI of the brain that had been reported as normal.