Brazilian purpuric fever
Brazilian purpuric fever is a systemic disease beginning 1-3 weeks after acute bacterial conjunctivitis. It is caused by Haemophilus influenzae, biogroup aegyptius. Outbreaks were described in several Brazilian towns & 2 cases were reported in Australia but none reported since the early 1990s.
CASES/YEAR
0 (US); 50 (Global)
OTHER NAMES
Haemophilus influenzae, biogroup aegyptius, infection;
INCUBATION
24 hours to 3 days
INITIAL SYMPTOMS
A systemic disease beginning 1-3 weeks after acute bacterial conjunctivitis. [CCDM, p. 125]
COMMENTS
Acute bacterial conjunctivitis may be spread by gnats and flies in some areas of the world. [CCDM, p. 126] Findings include high fever, vomiting, abdominal pain, petechiae, purpura, necrosis of digits, thrombocytopenia, prolonged prothrombin time, and shock. [ID, p. 1729] Conjunctivitis is followed up to 15 days later by purpura fulminans (high fever, vomiting, shock, and purpura) with a mortality rate of 40-70%. The virulence factors have not been identified. Several outbreaks in children were reported in Brazil, but no confirmed cases since 1993. [Guerrant, p. 1003]
SCOPE
70% case-fatality rate in the 100+ cases reported in Brazil; [CCDM, p. 125-6] Outbreaks described in several Brazilian towns & 2 cases were reported in Australia but none reported since early 1990s; [PPID, p. 2749]
SIGNS & SYMPTOMS
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>fever
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G abdominal pain
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G nausea, vomiting
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H thrombocytopenia
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O conjunctivitis, acute
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S petechiae and ecchymoses
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*sepsis
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*shock
ENTRY
Skin or Mucous Membranes (Includes Conjunctiva)
TREATMENT
"For BPF, systemic treatment is required; isolates are sensitive to both ampicillin and chloramphenicol and resistant to trimethoprim-sulfamethoxazole. Oral rifampicin may be more effective than local chloramphenicol in eradication of the causal clone, and may be useful in prevention among children with Brazilian purpuric fever clone conjunctivitis." [CCDM, p. 126]
REFERENCES FOR CASES/YEAR
1.
2. (Global) Guesstimate: 50 cases/year;