Case Report: Group B Streptococcus meningitis in an adolescent 

Abstract

Streptococcus agalactiae (group B Streptococcus, GBS) usually colonizes the gastrointestinal and lower genital tracts of asymptomatic hosts, yet the incidence of invasive disease is on the rise . We describe a case of an 18 year old woman, recently diagnosed with lupus, who reported a spontaneous abortion six weeks prior to her hospitalization. She presented with fever, altered mental status, and meningeal signs, paired with a positive blood culture for GBS. Magnetic resonance imaging of her brain demonstrated an extra-axial fluid collection, and she was diagnosed with meningitis. She received prolonged intravenous antibiotic therapy and aggressive treatment for lupus, leading to clinical recovery. This case illustrates the importance of recognizing GBS as a potential pathogen in all patients presenting with CNS infection .

Streptococcus agalactiae septicemia in a patient with diabetes and hepatic cirrhosis

“… 8 The most involved sites of infection are the skin, soft tissue, bone, joints, urinary tract, lungs, peritoneum, and the genital tract. 9 , 10 Endocarditis is uncommon, but bacteremia of unknown origin is frequently documented. 10 GBS meningitis among adults is rare, accounting for no more than 4% of the invasive infection cases involving this pathogen, 3 and representing only 0.3-4.3% of all cases of bacterial meningitis.…”

“… 3 However, for unknown reasons, meningitis during pregnancy and puerperium is very rare, although well reported. 9 , 12 - 14 Intriguingly, a peripartum streptococcal infection is more common in puerperas after a cesarean section, but virtually all cases of GBS meningitis occur after vaginal delivery. 13 It is speculated that the increased pelvic venous pressure during vaginal delivery is somehow responsible for this association.…”