Implications of Haemophilus influenzae Biogroup aegyptius Hemagglutinins in the Pathogenesis of Brazilian Purpuric Fever

Brazilian purpuric fever (BPF) is an acute disease caused by Haemophilus influenzae biogroup aegyptius; it is characterized by fever, purpura, and hypotensive shock and is usually fatal. The factors responsible for bacterial virulence and pathogenesis are poorly known. Hemagglutinins have been frequently associated with bacterial virulence, and, in the present study, hemagglutinating activity was detected in extracellular products from H. influenzae biogroup aegyptius strains isolated from patients with BPF. A 60–kilodalton (kDa) molecule absorbable by human O-type erythrocytes was identified by an immunoblot assay; a corresponding fraction was chromatographically purified, and its pathogenic effect was evaluated. Rabbits injected intravenously with either the whole bacterial extracellular product or the 60-kDa fraction showed reactions similar to those seen in patients with BPF: purpura, congestion, and fibrin thrombi in the inner organs. We suggest that this hemagglutinating factor is one of the major pathogenic components of BPF.