Group B Streptococcal Metastatic Endophthalmitis in an Elderly Man Without Predisposing Illness

Matsuo, Kenji; Nakatuka, Kazuo; Yano, Yoshiki; Fujishima, Wakako; Kashima, Kenji

doi:10.1016/s0021-5155(98)00020-3

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…agalactiae is responsible for pneumonia and adult invasive infections (5,7,10,14,20,21,23,26,27) including bacteremia, endocarditis (sometimes associated with vertebral infections), endophtalmitis, and meningitis in patients for whom the genital tract is unlikely to be the portal of entry (7,13,20). By comparing MLST characteristics of strains from a single anatomic site, we found that strains isolated from the throat differed from genital strains and belonged mostly to STs 1, 8, and 23, three STs previously described as being involved in infections of nonpregnant adults (17).…”

Section: Discussionmentioning

confidence: 99%

“…agalactiae infections in nonpregnant adults have been reported increasingly since the 1970s (5,7,10,14,20,21,23,26,27). The major clinical forms consist of skin, soft tissue, and bone infections; bacteremia; urinary tract infections; pneumonia; and peritonitis.…”

mentioning

confidence: 99%

“…Risk factors have been identified (16) and include an age of over 60 years and diagnoses of diabetes, cancer, decubitus acutus, AIDS, longcourse corticotherapy, chronic renal disease, cirrhosis, and neurological vessel disorders. However, cases of invasive S. agalactiae infections in immunocompetent nonpregnant adults have recently been reported (7,20,21,23). The physiopathology of these infections is not well understood and may be linked in part to S. agalactiae strains with particular properties.…”

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confidence: 99%

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Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

et al. 2008

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Streptococcus agalactiae carriage was evaluated by sampling four body sites in a group of 249 healthy individuals including both sexes and a wide range of ages; the aims were to study the population structure of colonizing strains by multilocus sequence typing (MLST) and to evaluate their diversity by serotyping, SmaI macrorestriction analysis, and PCR screening for genetic markers of highly virulent clones for neonates. The prevalences of carriage were 27% in women and 32% in men. The major positive body site was the genital tract (23% in women and 21% in men); skin, throats, and anal margins were also positive in 2%, 4%, and 14%, respectively. These human-colonizing strains belonged mostly to serotypes III (24%), Ia (21%), V (18%), and Ib (17%). Twenty-three sequence types ( Streptococcus agalactiae is the pathogen most commonly responsible for maternofetal and neonatal infections, and serogroup III sequence type (ST) 17 strains of this species have been identified as more likely to cause these infections (3,17,(24)(25)(26)28).S. agalactiae infections in nonpregnant adults have been reported increasingly since the 1970s (5,7,10,14,20,21,23,26,27). The major clinical forms consist of skin, soft tissue, and bone infections; bacteremia; urinary tract infections; pneumonia; and peritonitis. More rarely, S. agalactiae is responsible for septic arthritis, meningitis, and endocarditis. Risk factors have been identified (16) and include an age of over 60 years and diagnoses of diabetes, cancer, decubitus acutus, AIDS, longcourse corticotherapy, chronic renal disease, cirrhosis, and neurological vessel disorders. However, cases of invasive S. agalactiae infections in immunocompetent nonpregnant adults have recently been reported (7,20,21,23). The physiopathology of these infections is not well understood and may be linked in part to S. agalactiae strains with particular properties.Reports on the genetic characteristics of the strains associated with infections in adults showed that they are diverse and belong mostly to serotypes Ia, III, and V (5, 14) and clonal complexes 1, 9, 17, 19, and 23 (17).The portal of entry of these infections in adults is not often well documented. A better knowledge of the genetic characteristics of the S. agalactiae strains colonizing various body sites would contribute to a better understanding of the origin of infections in adults. Although the molecular features of S. agalactiae strains isolated during infectious diseases have been described in many cases, little is known about the molecular characteristics of human-colonizing strains. Therefore, we screened for S. agalactiae carriage in 249 healthy individuals of both sexes; the individuals were living at home and covered a range of ages, from the start of the teenage period until old age. Genital, skin, throat, and anal margin carriage was sampled by self-swabbing. The strains isolated were serotyped. The population structure of the strains was investigated by multilocus sequence typing (MLST). The genetic diversity of isolates was ev...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

et al. 2008

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“…In the last 15 years, our affiliated institutions (Tohoku University Hospital and Gifu University Hospital), located in Japan, have seen at least 6 cases of EBE caused by GBS in elderly patients. Moreover, an online search revealed 10 more cases in Japan [9][10][11][12][13][14][15][16][17][18]. Thus, at least 35 cases of EBE caused by GBS in adults have been reported in English or Japanese [2,.…”

Section: Introductionmentioning

confidence: 99%

Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases

et al. 2020

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Background: Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Methods: Retrospective case series and literature review. Results: In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection focus was endocarditis (37%). Conclusions: DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

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“…Endogenous endophthalmitis caused by GBS is very rare in non-pregnant adults, accounting for only 5.2% of bacterial endogenous endophthalmitis cases, only 21 of which have been reported in the literature worldwide [ 2 9 10 11 12 13 14 15 16 17 18 19 ]. In contrast to the present case, 18 (85.7%) of these 21 cases had predisposing factors such as old age, diabetes mellitus, cardiac diseases, malignant diseases, and immunosuppression ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary toStreptococcus agalactiaein a Healthy Adult: Case Report and Literature Review

et al. 2017

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Endogenous endophthalmitis secondary to group B Streptococcus (GBS) is extremely rare, particularly in healthy adults. However, the visual prognosis is poor. We report the first South Korean case of GBS infective endocarditis presenting as endogenous endophthalmitis and skin and soft tissue infection. Cultures of blood, vitreous humor, and pus from skin aspirates yielded a penicillin-susceptible serotype V strain of Streptococcus agalactiae. After 6 weeks, the patient completely recovered from GBS infective endocarditis. However, despite early antibiotic treatment and early surgical intervention, the patient's right eye developed phthisis bulbi and was a candidate for evisceration.

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Group B Streptococcal Metastatic Endophthalmitis in an Elderly Man Without Predisposing Illness

Cited by 11 publications

References 15 publications

Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

Molecular Characterization of Human-Colonizing Streptococcus agalactiae Strains Isolated from Throat, Skin, Anal Margin, and Genital Body Sites

Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases

Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary toStreptococcus agalactiaein a Healthy Adult: Case Report and Literature Review

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