Suspected Brazilian Purpuric Fever, Brazilian Amazon Region

摘要

To the Editor: Brazilian pur-puric fever (BPF), a Haemophilus aegyptius–caused febrile hemorrhagic illness of children that begins with conjunctivitis and has a case-fatality rate of 40%–90% (1,2), was fi rst rec-ognized during a 1984 outbreak. Be-fore June 2007, 69 cases were reported worldwide; 65 were from Brazil (1–3). To our knowledge, the disease had not been reported in the Amazon region until this investigation, which was precipitated by the report of 5 cases of a compatible syndrome in Anajás, Pará State, Brazil, in August 2007.To determine whether recent re-ports of BPF were accurate, we re-viewed medical records of the hospi-tal in Anajás. We identifi ed cases by using the following defi nition: fever >38.5oC , abdominal pain, vomiting, purpura, and antecedent conjuncti-vitis during July 1–September 30, 2007, in a child 3 months–10 years of age; absence of signs or symptoms of meningitis in those children; and laboratory exclusion of meningococ-cal infection. In addition, we searched retrospectively and prospectively for conjunctivitis among pupils of the elementary schools of Anajás dur-ing July–September 2007. We found 7 children with illnesses that met our case defi nition