To the Editor.
—We read with interest the article in the May issue of the Archives (1981;141:795-796) by de Sa Pereira and associates that reported a case of Haemophilus influenzae sepsis secondary to biliary infection in an adult. In this patient, sepsis occurred after a percutaneous liver biopsy was performed, and biliary tract obstruction secondary to carcinoma of the pancreas was found at laparotomy. The authors comment that serious H influenzae infections in adults are uncommon, especially those involving the biliary tract. During a two-year period, we have seen 12 episodes of H influenzae bacteremia in 12 adult patients, and in two cases, it was related to biliary disease.
Report of Cases.
—A 31-year-old man experienced rupture of a hydatid cyst into the bile ducts and the presence of multiple scolices in the biliary tract. The other patient was a 59-year-old man with an ampullary carcinoma. Laboratory data included the