Several multiple-dose protein-polysaccharide conjuf gate vaccines are licensed in the United States for H. influenzae type b. These vaccines have substantially re« duced the incidence of severe invasive infections caused by type b organisms, and vaccination of children starting at 2 months of age is strongly recommended.
Rifampin chemoprophylaxis is recommended for all household contacts of index cases of H. influenzae type b meningitis in which there is at least one unvac-cinated contact younger than 4 years of age. Children and staff of daycare centers should also receive rifampin prophylaxis if at least two cases have occurred among" the children.3
20-year-old man presented to the emergency .department with a history of temperature up to F and mild respiratory distress. He reported that he Jjai the worst sore throat of his life and was having difficulty swallowing. On physical examination, the patient was found to have a "cherry-red" epiglottis, ¡lood and throat cultures were obtained, and the patient was begun on treatment with cefotaxime. An endotracheal tube was placed for 48 hours until the inflammation of the epiglottis subsided. The throat gulture grew normal respiratory microbiota, but a gramnegative rod was isolated from the blood culture in 24 "h irs only on chocolate agar.
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