98
Letters to the Editor
should also ensure that all relevant information is forwarded with specimens to the reference laboratory. Alternatively, a copy of the original request form should be sent. T h e incompleteness of information provided on request forms hinders surveillance, may delay or even prevent the detection of outbreaks and presents an unnecessary obstacle to the researcher.
The Medical School, Framlington Place, Newcastle Upon Tyne, NE2 41-11-1, U.K.
R. S. Bhopal
Urinary tract infection caused b y Haemophilus parainfluenzae
Accepted for publication 5 June 199o Sir, T h e recent report by M o r g a n and H a m i l t o n - M i l l e r 1 serves as yet another reminder of the importance of ' f a s t i d i o u s ' organisms in the genesis of urinary tract infections. T h e r e have been two previous reports of infection with Haemophilus parainfluenzae, one of which was confirmed by isolation of the organism f r o m urine obtained by suprapubic aspiration.2 Since reporting that case, I have seen two further cases of H. parainfluenzae urinary tract infection, both associated with nephrolithiasis. I feel for these organisms to be reliably detected the use of supplementary media should be based on the result of a G r a m - s t a i n e d film of the urine. Regrettably, the microbiological examination of urine is so often the province of the most junior technical staff. With a little more vigilance, however, the diagnostic yield f r o m such examinations should be increased.
Regional Infectious Diseases Unit City Hospital, Greenbank Drive, Edinburgh EHzo 5SB, Scotland, U.K.
Clayton L. Golledge
References I. Morgan, MG, Hamilton-Miller JMT. Haemophilus influenzae and H. parainfluenzae as urinary pathogens. J Infect 199o; 2o: I43-I45. 2. Golledge CL. Urinary infection and Haemophilus species. Med J Aust 1987; 147: IO3.
A problem with oral rifampicin in the prophylaxis o f meningococcal infection
Accepted for publication 5 June 199o Sir, A previously healthy 2 o - m o n t h - o l d boy was admitted to hospital with a 4 days' history of cough, coryza, rash, high fever and v o m i t i n g : On examination he was febrile (temperature 38 °C), with a diffuse erythematous maculopapular rash on the trunk and limbs. T w o small patches of p u r p u r a were present on the left leg. M e n i n g i s m was absent. Examination of C S F was normal. H e was given intravenous penicillin for suspected meningococcal septicaemia and made a full recovery. Blood cultures grew Neisseria meningitidis group C. T h e day after the patient was admitted to hospital, his two household contacts (36-
Letters to the Editor
should also ensure that all relevant information is forwarded with specimens to the reference laboratory. Alternatively, a copy of the original request form should be sent. T h e incompleteness of information provided on request forms hinders surveillance, may delay or even prevent the detection of outbreaks and presents an unnecessary obstacle to the researcher.
The Medical School, Framlington Place, Newcastle Upon Tyne, NE2 41-11-1, U.K.
R. S. Bhopal
Urinary tract infection caused b y Haemophilus parainfluenzae
Accepted for publication 5 June 199o Sir, T h e recent report by M o r g a n and H a m i l t o n - M i l l e r 1 serves as yet another reminder of the importance of ' f a s t i d i o u s ' organisms in the genesis of urinary tract infections. T h e r e have been two previous reports of infection with Haemophilus parainfluenzae, one of which was confirmed by isolation of the organism f r o m urine obtained by suprapubic aspiration.2 Since reporting that case, I have seen two further cases of H. parainfluenzae urinary tract infection, both associated with nephrolithiasis. I feel for these organisms to be reliably detected the use of supplementary media should be based on the result of a G r a m - s t a i n e d film of the urine. Regrettably, the microbiological examination of urine is so often the province of the most junior technical staff. With a little more vigilance, however, the diagnostic yield f r o m such examinations should be increased.
Regional Infectious Diseases Unit City Hospital, Greenbank Drive, Edinburgh EHzo 5SB, Scotland, U.K.
Clayton L. Golledge
References I. Morgan, MG, Hamilton-Miller JMT. Haemophilus influenzae and H. parainfluenzae as urinary pathogens. J Infect 199o; 2o: I43-I45. 2. Golledge CL. Urinary infection and Haemophilus species. Med J Aust 1987; 147: IO3.
A problem with oral rifampicin in the prophylaxis o f meningococcal infection
Accepted for publication 5 June 199o Sir, A previously healthy 2 o - m o n t h - o l d boy was admitted to hospital with a 4 days' history of cough, coryza, rash, high fever and v o m i t i n g : On examination he was febrile (temperature 38 °C), with a diffuse erythematous maculopapular rash on the trunk and limbs. T w o small patches of p u r p u r a were present on the left leg. M e n i n g i s m was absent. Examination of C S F was normal. H e was given intravenous penicillin for suspected meningococcal septicaemia and made a full recovery. Blood cultures grew Neisseria meningitidis group C. T h e day after the patient was admitted to hospital, his two household contacts (36-
