SUSPECTED BRAZILIAN PURPURIC FEVER IN A TODDLER WITH OVERWHELMING EPSTEIN-BARR-VIRUS INFECTION

We describe a toddler from Connecticut who developed purulent conjunct ivitis, fever, and a morbilliform rash. Blood cultures were positive f or Haemophilus influenzae biogroup aegyptius; further investigation wa s performed to assess the possibility that the illness was consistent with Brazilian purpuric fever, which, to our knowledge, has not been r eported in the United States. This isolate shared morphological and so me biochemical characteristics with previously studied H, influenzae b iogroup aegyptius strains but differed according to slide agglutinatio n testing, plasmid characterization, and ribotyping. Blood and tissue samples obtained during his hospitalization were also positive for Eps tein-Barr virus. The child died 8 days after hospitalization. Fifty ot her cases of invasive H. influenzae infection were identified by activ e surveillance studies. Of the 49 viable surveillance isolates, 10 wer e biotype III (two of which had the same ribotype as the strain from o ur case).