Haemophilus influenzae type b isolates resistant to ampicillin have been reported with increasing frequency since 1973.1 The mechanism of resistance is usually via production of a plasmid-mediated β-lactamase.2 We report the second clinical isolate of an ampicillin-resistant strain of H influenzae type b with no detectable β-lactamase activity. CASE REPORT A 20-year-old white woman was admitted to The Children's Hospital of Philadelphia with a three-day history of fever to 39 C, cough, tachypnea, and diarrhea. Past medical history was significant for the following: (1) recurrent upper and lower respiratory tract infections first noted at 5 years of age, (2) a selective deficiency of IgG and IgA documented at 8 years of age necessitating monthly immune serum globulin injections, (3) chronic, interstitial pulmonary fibrosis with resultant obstructive and restrictive lung disease, (4) severe cachexia, (5) a chronic, maculopapular facial rash, and (6) recurrent, bilateral serous otitis media and sinusitis.
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Offit et al. (1982) studied this question.