Ampicillin-resistant H influenzae cellulitis and shock in an adult

Over a three-day period, pharyngitis, neck swelling, deep voice, dysphagia, fever, and cellulitis of the anterior neck and upper chest developed in a 63-year-old woman. Sixteen hours following the institution of intravenous ampicillin, septic shock developed and the patient became comatose. Ampicillin-resistant Hemophilus influenzae type B was found in a culture taken from her blood and pharynx. In patients who have an upper respiratory tract infection and severe cellulitis of the neck, initial therapy should include chloramphenicol because of the possibility of ampicillin-resistant Hemophilus influenzae infection.