A six-month-old male child was brought to the opd with the chief complaint of fever, inability to feed and seizures since the morning. On examination, the child was found to have altered sensorium and neck rigidity. A lumbar puncture was carried out and CSF sent for examination. The cytology and biochemistry results were suggestive of pyogenic meningitis. Microscopic examination revealed the presence of Gram-negative coccobacilli. On culture on blood agar , the microbe shows the following phenomenon:

Correct Answer: Satellitism
Description: H.influenzae is a small (1.0 x 0.3  µm), Gram-negative, non-motile, non-sporing bacillus, exhibiting considerable pleomorphism. In sputum, it usually occurs as  clusters of coccobacillary  forms,  while in CSF from meningitis cases, long, bacillary and filamentous forms  predominate. Cells from young cultures  (18- 24 hours)  are usually coccobacillary, while older cultures are distinctly pleomorphic.  Strains isolated from acute infections are often capsulated. The bacillus  has  fastidious  growth  requirements.  The accessory growth  factors, named X and V,  present in blood are essential for growth.  It is  aerobic but grows anaerobically also. The optimum temperature is 3 7°C. It does not grow below 20°C. Some strains require  10% CO2,  especially for primary isolation from the clinical specimen. It grows on blood agar if a source of the V factor is  also provided.  When S.aureus  is  streaked  across  a  plate of blood agar on which a specimen  containing  H.infiuenzae  has  been inoculated,  after overnight incubation, the colonies of H.influenzae  will  be  large  and well  developed  alongside  the streak of staphylococcus,  and smaller farther away.  This  phenomenon  is  called  satellitism  and demonstrates  the dependence  of H. influenzae  on  the V factor, which is available in high concentrations near staphylococcal growth  and  in  smaller  quantities  away from it. This is a routine test in clinical bacteriology for the identification of H. influenzae. Reference: Ananthanarayan Panekar microbiology 8th ed page no 333,334
Category: Microbiology
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