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Volume 15, Number 2—February 2009

Letter

Systemic Infection with Enteric Adenovirus in Immunocompetent Child with Haemophilus influenzae Disease

Nino KhetsurianiComments to Author , Suxiang Tong, Xiaoyan Lu, Shannon Reed, Dean Erdman, Angela Campbell1, Krongkaew Supawat, Sahas Liamsuwan, Narayanan Jothikumar, and Sonja Olsen2
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (N. Khetsuriani, S. Tong, X. Lu, S. Reed, D. Erdman, A. Campbell, N. Jothikumar); National Institute of Health, Nonthaburi, Thailand (K. Supawat); Queen Sirikit National Institute of Child Health, Bangkok, Thailand (S. Liamsuwan); International Emerging Infections Program, Nonthaburi (S. Olsen)

Main Article

Table

Clinical course of illness in 10-month-old boy with systemic infection with enteric adenovirus and Haemophilus influenzae disease, Thailand, 2003–2004*

Date, 2003 Events
Dec 7 Patient hospitalized with 6-day history of fever >38°C and somnolence; blood culture positive for Hemophilus influenzae; isolate not typed (unavailable for further characterization)
Dec 9 CSF results: pleocytosis (2,710 leukocytes/mm3, 94% neutrophils); protein 178 mg/dL; glucose 11 mg/dL; CSF culture positive for H. influenzae; CSF Gram stain positive for gram-negative coccobacilli; antimicrobial drug treatment (ceftriaxone) started
Dec 11 New onset seizures, ataxia, and maculopapular rash on entire trunk and all extremities; no diarrhea or respiratory symptoms; brain ultrasound scan results within normal limits; anticonvulsant therapy (phenobarbital) started
Dec 12 CSF results: pleocytosis (100 leukocytes/mm3, 60% neutrophils, 40% monocytes); protein 131.6 mg/dL; glucose 31 mg/dL; CSF bacterial culture, results negative; CSF Gram stain results negative; patient enrolled in the encephalitis study; initial specimens for the study collected
Dec 22 Brain ultrasound scan results within normal limits; antimicrobial drug treatment (ceftriaxone) discontinued
Dec 23 CSF bacterial culture results negative; CSF Gram stain results negative; anticonvulsant therapy (phenobarbital) discontinued
Dec 27 Patient discharged in improved condition; discharge diagnosis: H. influenzae meningitis and septicemia
Jan 7† Follow-up visit: full recovery without sequelae; convalescent-phase serum specimen obtained

*CSF, cerebrospinal fluid.
†2004.

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1Current affiliation: University of Washington, Seattle, Washington, USA.

2Current affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

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