Haemophilus influenzae in genitourinary tract infections.

ABSTRACT

PIP: This report was prompted by the isolation of Haemophilus influenza from cultures of specimens from genital sites in 11 patients. All cervical, vaginal, and urethral specimens submitted to the Section of Clinical Microbiology Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, for bacterial culture are routinely inoculated onto blood agar, eosinmethylene blue (EMB) agar, chocolate blood agar, Columbia colistin-nalidixic acid (CNA) blood agar, and unless previously directly inoculated by the attending physician, modified Thayer-Martin medium. As a rule, identification and reporting of isolates is limited to Neisseria gonorrhoeae, N. meningitidis, Gardnerella vaginalis, beta-hemolytic streptococci, Listeria monocytogenes, and Staphylococcus aureus. Cultures for anaerobic bacteria are restricted to endocervical or endometrial aspirates which are submitted to the laboratory in anaerobic transport vials. Cultures for fungi, Chlamydia trachomatis, and Ureaplasma urealyticum are performed by specific request, as is miscroscopic examination for Trichomonas vaginalis. Haemophilus influenzae was identified with the porphyrin test according to the Kilian's taxonomic system. Genital tract specimens from 11 patients yielded H. influenzae in pure or predominant culture. 9 patients were females, of whom 4 had vaginitis, usually with a yellowish, foul smelling discharge. 2 had IUD-related endometritis and parametritis, 1 had an incomplete septic abortion, and 1 had probable urethral syndrome. 2 males had urethritis. Cultures were negative for N. gonorrhoeae in every case and for C. trachomatis in the 6 patients whose specimens were cultured for this agent. Only 2 women -- 1 with vaginitis and 1 with probable urethral syndrome -- had G. vaginalis in cultures of vaginal secretions, while U. urealyticum was isolated from vaginal or cervical secretions of 3 of 4 women cultured for the organism.