Background: Since the introduction of Haemophilus influenzae type b vaccines, invasive disease due to Haemophilus influenzae serotype a (Hia) has been reported with increasing frequency. Methods: This study is based on hospital-based surveillance for Hia meningitis over a 5-year period. Results: Thirty-five patients with H. influenzae meningitis were hospitalized and 12 were serotype a. Hia was detected in blood and cerebrospinal fluid by culture or reverse transcription polymerase chain reaction. Patients' median age was 10 months, 7 (58%) boys and 5 (41%) girls. Ten (83%) children had received at least 1 vaccine dose against Haemophilus influenzae type b. All patients were treated with ceftriaxone for a median period of 11 days. The main complications described were empyema in 5 (41%) and seizures in 3 (25%) patients. Two (16.6%) patients died due to cerebral damage and shock. Conclusions: Invasive disease due to Hia affecting young children accounts for considerable morbidity and mortality.

Niemann-Pick disease type C is an innate error of lysosomal storage metabolism with an autosomal recessive inheritance pattern. The disease causes intracellular cholesterol accumulation and changes in sphingolipid metabolism. If cholesterol accumulates, the signs and symptoms of visceral involvement predominate. Neurological involvement results from sphingolipid accumulation. A 7-year-old student was referred to a tertiary service for the investigation of asymptomatic splenomegaly. Following an extensive examination, he was diagnosed with Niemann-Pick disease type C. Interestingly, this case's only symptom was splenomegaly.

ExtEnsivE RElapsing CERviCal lymphadEnitis duE to StreptococcuS pSeudoporcinuS in an infantTo the Editors: S treptococcus pseudoporcinus is a Grampositive, β-hemolytic coccus with biochemical characteristics similar to Group B Streptococcus (GBS or Streptococcus agalactiae) (GBS), first identified in 2006 and isolated from the female genitourinary tract. 1 Stoner et al 2 reported an association between colonization by S. pseudoporcinus and multiple sexual partners and genitourinary infections such as trichomoniasis, geni-