Haemophilus influenzae type b brain abscess complicating meningitis: case report.

A 7-month-old child developed beta-lactamase negative Haemophilus influenzae type b meningitis which was treated with parenteral ampicillin and chloramphenicol for two days and ampicillin for eight additional days. She was readmitted two days after discharge on the 14th day after the initial hospitalization because of a suspected relapse of meningitis. Cultures of CSF and blood yielded no growth, and therapy with ampicillin and chloramphenicol was discontinued after three days. After discharge, her fontanel became full and a large, right, frontoparietal brain abscess was found on her third admission on day 25. Pus from the abscess yielded beta-lactamase negative H influenzae type b but CSF and blood yielded no growth. The abscess resolved after needle aspiration of pus and 4 weeks of therapy with ampicillin and chloramphenicol. It is speculated that this rare complication of H influenzae meningitis arose from a focal infection in an area of brain necrosis that resulted from the initial meningitis.