Sir.—Bacterial meningitis caused by nontypeable Haemophilus influenzae is rare. A review of the literature revealed three cases of adult patients who were immune competent1 and a substantial number of cases of newborns with sepsis and meningitis.2,3 However, no case of an adolescent with nontypeable H influenzae has been reported to our knowledge.
Patient Report.—The patient was a 15-year-old white boy of Arabic descent, born in Venezuela and living in the United States since the age of 4 years. On admission, he had a 1-day history of temperatures to 41°C, diffuse abdominal pain, and headache. The patient's past medical history included an episode of viral meningitis at age 4 years. Past illnesses were not unusual, and growth and development were normal.
The physical examination revealed a well-oriented but lethargic and somewhat irritable patient with a temperature of 39°C. Nuchal rigidity was minimal, and he had normal reflexes