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Pathogenesis and Therapy

Venusto H. San Joaquin, MD; Harris R. Stutman, MD; Melvin I. Marks, MD

Am J Dis Child. 1984;138(5):455-458.

Abstract
• A model of human Hemophilus influenzae type b meningitis was developed in infant rabbits infected intranasally. The pathogenesis and course resembled that in human beings; bacteremia was followed by meningitis with a high mortality. Pretreatment of the nasopharyngeal mucosa with 0.5% trypsin or normal saline significantly increased the rate of bacteremia. Death was age related. Intranasal challenge with type f and nontypeable H influenzae was associated with transient bacteremia. Our results suggest that factors on the respiratory tract epithelial cell surface influence colonization and infection with H influenzae type b and confirm the importance of other host and parasite factors. Intravenous aztreonam resulted in a peak CSF concentration that was 6% to 7% of the serum concentration in infected meninges but only 2% to 3% in normal meninges. Aztreonam reduced mortality in established H influenzae type b meningitis from 88% in untreated animals to 9%.

(AJDC 1984;138:455-458)

Author Affiliations
From the Division of Infectious Diseases, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City.

Footnotes
Reprint requests to Division of Infectious Diseases, Department of Pediatrics, University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190 (Dr Marks).

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