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Sir.—I recently cared for a previously healthy 13-month-old boy with meningitis due to Haemophilus influenzae. This was diagnosed by positive CSF and blood cultures obtained after 12 to 18 hours of persistent vomiting and progressively worsening lethargy.
Twenty-four hours after admission of this child, I was called to see his 3-year-old brother, who had begun vomiting six hours previously. Though his physical findings were entirely within normal limits, his temperature was 39.1 °C; WBC count, 10,800/cu mm, with a marked left shift to the left. Chest roentgenogram showed a definite alveolar infiltrate in the right upper lobe.
Blood and throat cultures yielded H influenzae sensitive to ampicillin. Intramuscular administration of ampicillin in a dose of 200 mg/kg brought about resolution of this child's fever within 24 hours. The brother with meningitis was fever free within 48 hours after treatment with ampicillin, 400 mg/kg intravenously, was begun. His culture had