Streptococcus agalactiaeMeningitis in Adult Patient: A Case Report and Literature Review

Abstract

We report a case of group B streptococcus meningitis in a 72-year-old female patient who was admitted in our hospital with a 21-day history of bilateral lower thigh pain and swelling associated with fever, headache, and vomiting. Her past medical history was remarkable for DM type 2, hypertension, and hypothyroidism. Upon admission, examination showed bilateral warmth and tender soft tissue swelling around the knees and MRI showed cellulitis of distal thirds of both thighs. The next day, the patient became drowsy. Neurologic examination showed neck rigidity and right sided hemiparesis. Cerebrospinal fluid and blood cultures yielded group B streptococcus sensitive to ceftriaxone, penicillin G, and vancomycin. The patient received ceftriaxone for a total of 14 days after which she improved and was discharged from the hospital with right sided weakness.

<p>Group B Streptococcal Meningitis in a Healthy Young Woman: A Case Report</p>

“…Although it normally colonizes in the gastrointestinal and genitourinary tract of an asymptomatic hosts, 2 GBS is one of the leading causes of sepsis and meningitis in children younger than 3 years old, especially in the neonates. 1,2 It is, however, an uncommon cause of community-acquired bacterial meningitis in adults where it accounts only in 1.3% of total meningitis cases in adult, 2 and usually occurs in the elderly or in patients with severe underlying comorbidities that increased risk of infections, such as diabetes mellitus, liver cirrhosis, advance kidney disease, chronic alcoholism, or having a distant foci of infections. 3,4 The clinical manifestation of GBS meningitis is similar with meningitis caused by other pathogens, which is acute onset and associated with neurological dysfunction.…”

“…Apart from that, GBS meningitis is considered very dangerous as the mortality rate is about 27-34%, which is relatively higher compared to meningococcal meningitis. 1 Factors associated with high mortality include advanced age, the presence of neurological complications such as coma or focal localizing signs, and systemic complications such as respiratory failure, kidney failure, shock, or consumption coagulopathy. [2][3][4] In terms of treatment, the majority of GBS infections are fortunately still sensitive to the penicillin group of antibiotics, as well as cephalosporins and vancomycin as the alternatives.…”

“…It is an uncommon cause of bacterial meningitis in adults, with a high mortality rate, and usually affects the elderly or patients with chronic illnesses such as diabetes, liver cirrhosis, renal failure, and many others. 1 Here, we report a case of a GBS meningitis in a previously healthy young lady, and this uncommon cause of bacterial meningitis in adults is the center of discussion in this case report.…”

Ischaemic stroke caused by Group B Streptococcus associated meningoencephalitis in young, immunocompetent adults – a case series and systematic review of literature

“…7,8 It infrequently causes primary meningitis in adults, but these cases have a reported mortality rate of 34%. 9,10 Therefore, our cases are unusual given the relatively young age of onset in patients who were apparently immunocompetent.…”

An epidural collection due to streptococci Agalactiae

“…Streptococcus agalactiae, also known as Group B Streptococcus (GBS), has traditionally been associated with neonates and pregnant women. Invasive diseases due to S. agalactiae are increasing in non-pregnant adults, especially with medical underlying conditions such as diabetes mellitus or neoplasia [1,2]. Although S. agalactiae spondylodiscitis is an unusual manifestation of invasive GBS disease in adults, clinicians should be aware of this clinical entity.…”