Apr 28, 1988 - Preto Campus, Faculty of Medicine, University of Sâo Paulo,. Ribeirà o Preto ...... Case-associated strains are not included on the map. RESULTS ...... Committee for Clinical Laboratory Standards, Villanova, Pa. 28. Olsvik, 0.
Vol. 26, No. 8
JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1988, p. 1524-1534
0095-1137/88/081524-11$02.00/0 Copyright (O 1988, American Society for Microbiology
Biochemical, Genetic, and Epidemiologic Characterization of Haemophilus influenza Biogroup Aegyptius (Haemophilus aegyptius) Strains Associated with Brazilian Purpuric Fever DON J. BRENNER,'* LEONARD W. MAYER,' GEORGE M. CARLONE,' LEE H. HARRISON,' WILLIAM F. BIBB,' MARIA CRISTINA DE CUNTO BRANDILEONE,2 FRANCES O. SOTTNEK,' KINUE IRINO,2 MICHAEL W. REEVES,' JANA M. SWENSON,3 KRISTIN A. BIRKNESS,' ROBBIN S. WEYANT,4 SETH F. BERKLEY,' TONI C. WOODS,' ARNOLD G. STEIGERWALT,1 PATRICK A. D. GRIMONTS ROGER M. McKINNEY,' DAVID W. FLEMING,' LINDA L. GHEESLING,' ROBERT C. COOKSEY,3 ROBERT J. ARKO,6 CLAIRE V. BROOME,' AND THE BRAZILIAN PURPURIC FEVER STUDY GROUPt
Meningitis and Special Pathogens Branch, Division of Bacterial Diseases,' Hospital Infections Program, and Sexually Transmitted Diseases Program,6 Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia 30333; Bacteriology Division, Adolfo Lutz Institute, Sâo Paulo, Brazil2; Department of Experimental Pathology, Emory University, Atlanta, Georgia 303224; and Enterobacteriology Department, Institut Pasteur, Paris, France5 Received 28 January 1988/Accepted 28 April 1988
Brazilian purpuric fever (BPF) is a recently recognized fulminant pediatric disease characterized by fever, with rapid progression to purpura, hypotensive shock, and death. BPF is usually preceded by purulent conjunctivitis that has resolved before the onset of fever. Both the conjunctivitis and RPF are caused by Haemophilus influenzae biogroup aegyptius (formerly called H. aegyptius). Isolates from 15 BPF cases, mainly from blood or hemorrhagic cerebrospinal fluid, case-associated isolates from 42 persons in towns where BPF cases occurred, and control strains from 32 persons in towns without BPF cases were characterized biochemically, genetically, and epidemiologically. Results indicated that a single clone was responsible for all BPF cases identified in six Brazilian towns from 1984 through 1986. All of 15 (100%) case strains were the same clone as was 1 of 32 (3%) control strains (P =
