Branhamella catarrhalis pneumonia: report of 4 cases.

This is the first time Branhamella Catarrhalis has been identified as a lower respiratory tract pathogen in Taiwan. All 4 patients with B. catarrhalis pneumonia reported herein had a certain degree of underlying pulmonary dysfunction. Two patients had pure B. catarrhalis infection, whilst the other two had concomitant infections with Haemophilus influenzae or Viridans streptococci. Amongst the 3 strains of B. catarrhalis examined, all were capable of producing beta-lactamase. By using the Kirby-Bauer method, 2 of these strains were observed as penicillin resistant. Therefore, patients with poor clinical response to penicillin, ampicillin, and cephapirin were treated effectively with trimethoprim/sulfamethoxazole or ofloxacin. B. catarrhalis should no longer be regarded as a normal flora of the sputum in patients with lower respiratory tract infections. Beta-lactamase production should be tested for each isolated strain to avoid failure of penicillin therapy due to bacterial resistance.