[Hemophilus aphrophilus meningitis: report of one case]

Hemophilus aphrophilus, a gram negative, capnophilic slow growing bacillus, is a rarely recognized pathogen in meningitis and is most frequently seen in patients with either endocarditis or brain abscess. This article reported one case with Hemophilus aphrophilus meningitis. A 10-year-old boy presented at the emergency room with chief complaint of fever for 2 days and sudden onset of loss of consciousness. Hemophilus aphrophilus was isolated from the blood and cerebrospinal fluid. Aqueous penicillin and chloramphenicol were given for three weeks. The patient discharged without any sequelae. Three months later, fever and consciousness disturbance were noted again. No pathogen was isolated from the cerebrospinal fluid and blood culture this time, but CSF finding was consistent with bacterial meningitis. Aqueous penicillin and chloramphenicol were readministered for 30 days. The patient recovered smoothly. Because the patient had no history of CSF rhinorrhea or hypogammaglobulinemia, recurrence of the bacterial meningitis could be due to incomplete treatment during the first admission. Brain computed tomography (CT) done during the two admissions showed focal cortical enhancement in the fronto-temporo-parietal region. This is presumed to indicate infarction over these regions. The findings of brain CT are in accordance with the development of hemiplegia in the patient. It is still unknown, however, whether Hemophilus aphrophilus meningitis also causes a higher incidence of brain infarction, which was frequently noted in patients with Hemophilus influenzae meningitis.