rifampin and Laryngitis

To determine the efficacy of rifampin chemoprophylaxis in eradication of oropharyngeal carriage of Haemophilus influenzae type b, we conducted a multicenter, double-blind, placebo-controlled trial among household contacts of patients hospitalized for invasive HIB infection. Seventy-nine index patients and 400 close contacts were studied; 26.5% of contacts were colonized. The efficacy of rifampin (10 mg/kg/dose, 600 mg/dose maximum, twice daily for two days) in eradicating carriage was 52% and varied with age (75.6% in persons greater than or equal to 5 and 27% in those less than 5 years). Eradication rates in those less than 5 years were not significantly better than for placebo. No resistant isolates were encountered in sensitivity testing. The low efficacy of this rifampin regimen in young children precludes its routine use as a chemoprophylactic agent for family contacts. The occurrence of three cases of invasive HIB infection in individuals outside the defined contact group raises concern regarding the efficacy of any chemoprophylactic regimen.

Topics: Clinical Trials as Topic; Double-Blind Method; Epiglottis; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Laryngitis; Meningitis, Haemophilus; Microbial Sensitivity Tests; Oropharynx; Placebos; Pregnancy; Rifampin

The Rhodococcus equi is an aerobic gram positive pleomorphic bacillus, that was isolated for the first time like a producer of bronchopneumonia in young horses. Every time more often, it is being recognized as a pathogen in humans, mainly in the immunodepressed population. We described a case, until now exceptional, of laryngeal infection by Rhodococcus equi in a patient with positive serology for the virus of the human immunodeficiency (HIV), and we reviewed some clinical and epidemiological characteristics of the infections by this germ. The treatment is riphampicine and/or erythromycin, being the prognosis bad, because usually they are immunodepressed patients.

Topics: Acquired Immunodeficiency Syndrome; Actinomycetales Infections; Adult; Anti-Bacterial Agents; Antibiotics, Antitubercular; Drug Therapy, Combination; Erythromycin; Humans; Laryngeal Mucosa; Laryngitis; Male; Rhodococcus equi; Rifampin

Topics: Adult; Antitubercular Agents; Drug Therapy, Combination; Humans; Isoniazid; Laryngitis; Male; Pyrazinamide; Rifampin; Tongue; Tuberculosis, Pulmonary; Ulcer

Epiglottitis (supraglottitis) in the adult, once thought a rare entity, has been reported in the literature with increasing frequency since the late 1960s. Five cases occurring in our hospital over a 12-week period prompted this report. Historical and literature reviews followed by five case reports and discussion, illustrate the important diagnostic and therapeutic features of this disease.

Topics: Adult; Airway Obstruction; Epiglottitis; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Laryngitis; Male; Middle Aged; Rifampin; Staphylococcal Infections

Tolerance to beta-lactam antibiotics has been described with staphylococci and enterococci, but this phenomenon and its clinical significance in Haemophilus influenzae has not been reported. We have reported a case of bacteremic epiglottitis due to an ampicillin-tolerant, beta-lactamase-negative strain of Haemophilus influenzae type b which was cured with ampicillin therapy alone. The organism was not tolerant to moxalactam, cefotaxime, or rifampin. Rifampin therapy eliminated pharyngeal carriage.

Topics: Ampicillin; Cerebrospinal Fluid; Drug Therapy, Combination; Epiglottitis; Haemophilus Infections; Haemophilus influenzae; Humans; Laryngitis; Male; Middle Aged; Penicillin Resistance; Pharynx; Rifampin

Epiglottis (more properly supraglottitis) is a potentially life-threatening infection of the supraglottic larynx that is most often caused by Hemophilus influenzae type B (HITB). Intrafamily spread of HITB disease has been described often for meningitis, but is rarely reported in epiglottis. We describe two siblings seen concurrently with HITB epiglottitis and discuss prophylaxis of family members and close contacts.

Topics: Child, Preschool; Epiglottis; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Laryngitis; Male; Rifampin