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Thirty-eight patients (31 children and 7 adults) with meningococcal infection (sepsis and/or meningitis) were studied. The strain most frequently isolated was B (44.7%), followed by C (31.6%). Of the strains isolated, 52.6% were moderately resistant to penicillin (91.6% if only strain C was considered). No resistance to cephotaxime or chloramphenicol was found. Even though patients with moderately resistant strains treated with penicillin G evolved satisfactorily (minimum inhibitory concentrations 0.12-0.50 microgram/ml), the possible appearance of more resistant strains and/or of strains that produce beta-lactamase leads us to the conclusion that cephotaxime is the treatment of choice until an antibiogram is available.

Fever of unknown origin (FUO) is a frequent disorder in pediatric age. FUO is defined as the presence of fever over 38.4 centigrades in a patient for more than three weeks in which the etiology remains undetermined. From 30.736 consecutive admittances into our hospital, 180 patients with FUO were detected, and studied in a systematized way and according to a predetermined protocol. FUO was commonly found in children under six years of age. Our patients presented fever from three weeks to six and a half years of evolution; however, in the vast majority of the cases (n = 115) fever had a three weeks course. Several symptoms and physical manifestations other than fever were observed in our patients but they were widely variable and nonspecific. Infectious diseases were the commonest etiological factor encountered; among them, thyroid fever, and urinary tract infections were the most frequent infectious disorder found; in four children fever was associated to ampicillin administration; in 19 patients, fever was no demonstrated. A large number of laboratory investigations were done in the diagnosis of neoplastic diseases. We think that the study of a patient with FUO requires of a systematized approach.

One to 10% of the cases have cutaneous reactions caused by ampicillin. When this drug is associated to MI the percentage goes up to 90% of the cases. The physiopathogenic mechanism of the generalized exanthema in this association is unknown. The development of toxicity is postulated because these patients have no previous history of allergy to penicillin either before of after the cutaneous reaction. By a still obscure mechanism, MI predisposes or alters the patient sensibility to the drug and the cutaneous reaction appears. This picture cannot be attributed to MI because the exanthema that present is mild. Neither is this picture of allergy due to ampicillin, without relationship with the MI, because the reaction is not coincident with other descriptions of reactions by this drug. The clinic evidence, observed in patients with MI, and ampicillin, is of a strong relation between two factors and the cutaneous reaction. In our patient the eruption affected principally the sites exposed to the sun, that makes us think in a phototoxicity reaction. Despite this fact the tests done were negative. We agree with other authors that the administration of ampicillin in patients with ill-defined pharyngeal symptoms is contraindicated until infections mononucleosis is ruled out.

Cutaneous reaction by ampicillin, do present themselves with a greater frequency than other penicillin derivates and in general rule they are of the urticaria or exanthematous type. The administration to patients with infective mononucleosis or when it is applied together with allopurinol, the risk of cutaneous reactions is greater. There appears a twenty year old, female patient, who by reason of a febrile reaction with odinofagia, is medicated with ampicillin of 1500 milligrams daily, and this unchains generalized morbilliform exantheme, lightly desquamative-a-sole of the feet, hear skin, and being very showy the edema on face. Besides she presented a diffuse enantema. The clinic examination revealed macropolyadenopathy, hepatomegaly, splenomealy and mesosystolic blast. The laboratory showed 55% lymphocytosis, Turk cells and Downey cells. Erythrocyte sedimenation rate 16-36 mm/hs. Total hemolytic complement 105 U (V. N. 160-260). Hipergammaglobulinemia 2,11 mg/dl. Hypergammaglobulinemia total 2 mg/dl. Fosgefose selceline 204 mU/ml. TGO 120 mU/ml. Cholesterol 115 mg/dl. Hyperuricemic 115 mg/dl. Serology for Epstein-Barr virus: 1:40. The rest of proofs did not reveal data of importance. In the infective mononucleosis are described varied cutaneous manifestations which are fugacious and not very frequent. On the contrary the clinic aspect as the observed one in this case, has more intensive and generalized characteristics. It is considered a toxic phenomena because of the proved absence of sensibility to penicillin derivates. Authors advert on the administration of this drug in indefinite pharyngeal cases.