Haemophilus aegyptius bacteraemia in Brazilian purpuric fever. Brazilian Purpuric Fever Study Group.

Brazilian purpuric fever (BPF) is a fulminant, often fatal childhood illness that was first recognised in 1984. An outbreak in Serrana, São Paulo State in March to May, 1986, resulted in 11 cases. Haemophilus aegyptius was isolated from normally sterile body fluids in 10 children (9 from blood and 1 from cerebrospinal fluid contaminated with blood), consistent with a direct role for H aegyptius in the pathogenesis of BPF. The ability to define cases by positive blood cultures permitted an evaluation of the spectrum of illness of this disease. 5 culture-positive cases were clinically similar to those previously described; the other 5 had milder illness without petechial or purpuric skin manifestations at the time the bacterium was isolated. Blood cultures were a sensitive means of diagnosing BPF; cultures were positive in 5 of 6 patients that met the full clinical case definition. Treatment of conjunctivitis did not appear to prevent BPF. However, children treated with intravenous antimicrobials early in the systemic illness had a trend toward better survival, suggesting that early therapy may prevent progression of the illness.