Epiglottitis due to ampicillin-tolerant Haemophilus influenzae type b

Tolerance to beta-lactam antibiotics has been described with staphylococci and enterococci, but this phenomenon and its clinical significance in Haemophilus influenzae has not been reported. We have reported a case of bacteremic epiglottitis due to an ampicillin-tolerant, beta-lactamase-negative strain of Haemophilus influenzae type b which was cured with ampicillin therapy alone. The organism was not tolerant to moxalactam, cefotaxime, or rifampin. Rifampin therapy eliminated pharyngeal carriage.