Abscess formation by Haemophilus paraphrophilus secondary to a submandibular salivary calculus

Infections with Haemophilus species in chronic granulomatous disease: insights into the interaction of bacterial catalase and H2O2 production

Chronic granulomatous disease (CGD) is a rare inherited disorder in which phagocytes are incapable of generating bactericidal-reactive oxygen derivatives. Typically these patients are susceptible to life-threatening infections with catalase-producing organisms. Haemophilus species, particularly H. paraphrophilus, are not associated with CGD infections, because these organisms rarely if ever produce catalase. Haemophilus species are part of the indigenous oral microbial flora and, other than H. influenzae, are rarely recognized as pathogens. They are fastidious and require additional growth factors and capnophilic culture conditions for optimal growth and identification. Here we describe three cases of infection with non-H. influenzae (NHI) Haemophilus species in CGD patients. These organisms were catalase-negative and therefore not expected to be virulent in CGD patients, but they were also H(2)O(2) production-negative, thereby negating the putative loss of virulence of being catalase-negative. These are the first reports of NHI Haemophilus species in CGD and reinforce the critical need for careful microbiologic evaluation of infections in CGD patients.

Haemophilus paraphrophilus brain abscess

The clinical course of a patient with brain abscess due to Haemophilus paraphrophilus is described. The organism was recovered in pure culture from purulent material collected at surgery. The role of this organism as a human pathogen is reviewed.

Meningitis and brain abscess due to Haemophilus paraphrophilus

A case of meningitis and brain abscess due to Haemophilus paraphrophilus in a patient with congenital heart disease is reported. The abscess communicated with the cerebral ventricular system. Although the infecting strain was found to be highly sensitive to ampicillin, the patient died despite appropriate antimicrobial therapy. Characteristics distinguishing Haemophilus paraphrophilus and related species are discussed.