Early-Onset Fulminant Sepsis in a Preterm Neonate due to Streptococcus gallolyticus: A Case Report and Literature Review

Abstract

Streptococcus gallolyticus (SG) is an uncommon cause of neonatal infections. We describe the first case of fulminant lethal neonatal sepsis due to SG reported in literature. Our patient was an extremely low birth weight premature infant that was born to a mother with prolonged rupture of amniotic membranes and chorioamnionitis. We also review the cases of neonatal SG infections reported in literature. Fifty-eight percent neonatal SG infections presented in the first week of life. Importantly, SG meningitis is more commonly reported with early-onset infections compared to group B streptococcal meningitis which is more common with late-onset infections. SG must be included in differential for neonatal sepsis, particularly, in presence of meningitis in first week of life. Most cases are sensitive to penicillin, however, cases of reduced sensitivity to penicillin have also been reported.

Epidemiologic Changes of Neonatal Early-onset Sepsis After the Implementation of Universal Maternal Screening for Group B Streptococcus in Hong Kong

“…Previous literature reviews regarding EOS caused by S. bovis revealed similar clinical characteristics, except for 1 case reported by Williams et al who was born extremely preterm and died. 26,27 Because S. bovis is a commensal bacterium of the intestinal microbiome in healthy humans, it is possible that it exists in the anogenital region of mothers and spreads…”

“…Previous literature reviews regarding EOS caused by S. bovis revealed similar clinical characteristics, except for 1 case reported by Williams et al who was born extremely preterm and died. 26 , 27 Because S. bovis is a commensal bacterium of the intestinal microbiome in healthy humans, it is possible that it exists in the anogenital region of mothers and spreads to infants during the peripartum period. As the current EOS guidelines focus on GBS identification and IAP coverage for GBS carriers, while GBS EOS has decreased, there are no specific measures that would reduce S. bovis risk.…”

Neonatal Sepsis Caused by Streptococcus gallolyticus Complicated with Pulmonary Hypertension: A Case-Report and a Systematic Literature Review

“…[ 37 , 38 ] Additionally, although S. gallolyticus has been clearly linked with cases of endocarditis in adult patients, to our knowledge, only one case has been reported in the neonatal population; this patient recovered without sequelae [ 20 ]. The overall prognosis is encouraging, with three neonatal deaths by S. gallolyticus being recorded in the literature out of 67 cases of neonatal infection (including one extremely premature and extremely low birth weight neonate) and 2 cases complicated by severe neurologic sequelae [ 2 , 17 , 25 , 26 ]. Postmortem examination findings of the deceased neonates were not described in the literature.…”

“…A total of 26 articles reported 66 cases [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. For reasons of completeness, we decided to include in our review three cases of neonatal infection caused by S. bovis biotype II, since, according to the bibliography, neonatal infections caused by S. gallolyticus species (i.e., S. bovis biotype II/2) are much more common than neonatal infections caused by S. infantarius (i.e., S. bovis biotype II/1).…”

Late-Onset Meningitis in a Preterm Infant Caused by Streptococcus gallolyticus Subsp. Pasteurianus in Saudi Arabia: A Case Report and Literature Review

“…An increasing number of reports of neonatal sepsis, meningitis, and intrauterine infections caused by S. gallolyticus have been observed. 14 , 15 However, complications can vary, as observed in cases of liver abscesses and ventriculitis. 16 Insights gained from such cases are essential for early evaluation, detection, and prevention of complications.…”