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October 1981, Vol 135, No. 10 >
Article | October 1981

Management of Recurrent Invasive Haemophilus influenzae Infection FREE

Lazar Fruchter, MD; Richard Insel, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, Long Island Jewish-Hillside Medical Center, New Hyde Park, NY 11042 (Dr Fruchter).


Am J Dis Child. 1981;135(10):927-929. doi:10.1001/archpedi.1981.02130340033012.
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References
Comments

• A 4½-month-old infant had three separate episodes of invasive Haemophilus influenzae type b infection and did not produce antibody to the capsular polysaccharide of H influenzae b. Immunologic evaluation disclosed normal immunoglobulin and complement concentrations and normal T-cell number and function. In view of the persistent presence of type-specific capsular polysaccharide of H influenzae b (polyribophosphate [PRP]) in blood serum without any detectable anti-PRP antibody for 30 days following H influenzae b meningitis, monthly treatment with immune human serum globulin was undertaken until spontaneous production of anti-PRP antibody occurred. The patient's 4-year-old sibling was found to be a nasopharyngeal carrier and may have been a source for reinfection. A search for possible family carriers should be conducted in evaluating the conditions of patients with recurrent invasive H influenzae b infection. In addition, temporary treatment with immune human serum globulin should be considered.

(Am J Dis Child 1981;135:927-929)

REFERENCES

1 +
Peltola H, Käyhty H, Sivonen A, et al:  Haemophilus influenzae type b capsular polysaccharide vaccine in children: A double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland . Pediatrics 1977;;60:730-737.
2 +
O'Reilly RJ, Anderson P, Ingram DL, et al:  Circulating polyribophosphate in Haemophilus influenzae, type b meningitis . J Clin Invest 1975;;56:1012-1022.
3 +
Norden CW, Michaels RH, Melish M:  Serologic responses of children with meningitis due to Haemophilus influenzae type b . J Infect Dis 1976;;134:495-499.
4 +
Feigen RD, Stechenberg BW, Chang MJ, et al:  Prospective evaluation of treatment of Haemophilus influenzae meningitis . J Pediatr 1976;; 88:542-548.
5 +
Mayer MM:  Complement and complement fixation , in Kabat EA (ed): Experimental Immunochemistry , ed 2. Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 133-240.
6 +
Wybran J, Fudenberg H:  Thymus-derived rosette-forming cells in various human disease states: Cancer, lymphoma, bacterial and viral infections and other diseases . J Clin Invest 1973;;52:1026-1032.
7 +
Bianco C, Patrick R, Nussenzweig F:  A population of lymphocytes bearing a membrane receptor for antigen-antibody-complement complexes . J Exp Med 1970;;132:702-720.
8 +
Voller A, Bidwell D, Bartlett A:  Microplate enzyme immunoassays for the immunodiagnosis of viral infections , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washinton, DC, American Society for Microbiology, 1976;, pp 506-512.
9 +
Ward JI, Siber GR, Scheifele DW, et al:  Rapid diagnosis of Haemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis . J Pediatr 1978;; 93:37-42.
10 +
Stechenberg BW, Feigin RD:  Ampicillin-resistant followed by ampicillin-sensitive Haemophilus influenzae meningitis in a normal host . J Pediatr 1978;;92:229-231.
11 +
Robbins JB, Parke JC Jr, Schneerson R, et al:  Quantitative measurement of 'natural' and immunization-induced Haemophilus influenzae type b capsular polysaccharide antibodies . Pediatr Res 1973;;7:103-110.
12 +
Smith DH, Peter G, Ingram DL, et al:  Responses of children immunized with the capsular polysaccharide of Haemophilus influenzae type b . Pediatrics 1973;;50:637-644.
13 +
Michaels RH, Norden CW:  Pharyngeal colonization with Haemophilus influenzae type b: A longitudinal study of families with a child with meningitis or epiglottitis due to H influenzae type b disease . J Infect Dis 1977;;136:222-228.
14 +
Gessert C, Granoff DM, Gilsdorf J:  Comparison of rifampin and ampicillin in day care center contacts of H influenzae type b disease . Pediatrics 1980;;66:1-4.
15 +
Granoff DM, Daum RS:  Spread of Haemophilus influenzae type b: Recent epidemiologic and therapeutic considerations . J Pediatr 1980;;97:854-860.

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References

1 +
Peltola H, Käyhty H, Sivonen A, et al:  Haemophilus influenzae type b capsular polysaccharide vaccine in children: A double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland . Pediatrics 1977;;60:730-737.
2 +
O'Reilly RJ, Anderson P, Ingram DL, et al:  Circulating polyribophosphate in Haemophilus influenzae, type b meningitis . J Clin Invest 1975;;56:1012-1022.
3 +
Norden CW, Michaels RH, Melish M:  Serologic responses of children with meningitis due to Haemophilus influenzae type b . J Infect Dis 1976;;134:495-499.
4 +
Feigen RD, Stechenberg BW, Chang MJ, et al:  Prospective evaluation of treatment of Haemophilus influenzae meningitis . J Pediatr 1976;; 88:542-548.
5 +
Mayer MM:  Complement and complement fixation , in Kabat EA (ed): Experimental Immunochemistry , ed 2. Springfield, Ill, Charles C Thomas Publisher, 1971;, pp 133-240.
6 +
Wybran J, Fudenberg H:  Thymus-derived rosette-forming cells in various human disease states: Cancer, lymphoma, bacterial and viral infections and other diseases . J Clin Invest 1973;;52:1026-1032.
7 +
Bianco C, Patrick R, Nussenzweig F:  A population of lymphocytes bearing a membrane receptor for antigen-antibody-complement complexes . J Exp Med 1970;;132:702-720.
8 +
Voller A, Bidwell D, Bartlett A:  Microplate enzyme immunoassays for the immunodiagnosis of viral infections , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washinton, DC, American Society for Microbiology, 1976;, pp 506-512.
9 +
Ward JI, Siber GR, Scheifele DW, et al:  Rapid diagnosis of Haemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis . J Pediatr 1978;; 93:37-42.
10 +
Stechenberg BW, Feigin RD:  Ampicillin-resistant followed by ampicillin-sensitive Haemophilus influenzae meningitis in a normal host . J Pediatr 1978;;92:229-231.
11 +
Robbins JB, Parke JC Jr, Schneerson R, et al:  Quantitative measurement of 'natural' and immunization-induced Haemophilus influenzae type b capsular polysaccharide antibodies . Pediatr Res 1973;;7:103-110.
12 +
Smith DH, Peter G, Ingram DL, et al:  Responses of children immunized with the capsular polysaccharide of Haemophilus influenzae type b . Pediatrics 1973;;50:637-644.
13 +
Michaels RH, Norden CW:  Pharyngeal colonization with Haemophilus influenzae type b: A longitudinal study of families with a child with meningitis or epiglottitis due to H influenzae type b disease . J Infect Dis 1977;;136:222-228.
14 +
Gessert C, Granoff DM, Gilsdorf J:  Comparison of rifampin and ampicillin in day care center contacts of H influenzae type b disease . Pediatrics 1980;;66:1-4.
15 +
Granoff DM, Daum RS:  Spread of Haemophilus influenzae type b: Recent epidemiologic and therapeutic considerations . J Pediatr 1980;;97:854-860.

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