Management of recurrent invasive Haemophilus influenzae infection
L. Fruchter and R. Insel
A 4 1/2-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.
