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September 1982

Pseudo Relapse of Hemophilus influenzae Meningitis due to Echovirus Type 5

Author Affiliations

Cardinal Glennon Memorial Hospital for Children St Louis University School of Medicine St Louis

Am J Dis Child. 1982;136(9):864. doi:10.1001/archpedi.1982.03970450106026

Relapse of Hemophilus influenzae b meningitis, while uncommon, is a well-documented phenomenon occurring in perhaps 4% of patients treated initially with ampicillin sodium, while relapse following therapy with intravenous (IV) chloramphenicol has been documented rarely.1 We wish to report the case of an infant whose apparent relapse of H influenzae b meningitis following chloramphenicol therapy was due to echovirus type 5.

Report of a Case.—An 8-month-old girl was admitted to Cardinal Glennon Memorial Hospital for Children, St Louis, in August 1981 with a four-day history of fever (40 °C [104 °F]), poor feeding, and progressively increasing irritability. Physical examination showed an extremely irritable infant with a bulging anterior fontanelle and occasional "staring spells" not accompanied by convulsive activity. Initial examination of the CSF showed 5,300 WBCs, all of which were polymorphonuclear leukocytes, a glucose concentration of 3 mg/dL, and a protein concentration of 84 mg/dL. Peripheral complete blood