Journal List > Pediatr Infect Vaccine > v.25(1) > 1098703

Cho, Kim, Cho, and Choi: Late-Onset Group B Streptococcal Meningitis Complicated with Extensive Cerebral Infarction

Abstract

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

References

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Fig. 1.
Magnetic resonance image and angiography performed on the 4th hospital day showed (A, B) multifocal diffusion restriction at cortex of cerebral hemisphere and corpus callosum, (C) suspicious multifocal stenosis, and (D) extra-axial fluid collection at bilateral cerebral convexity.
piv-25-45f1.tif
Fig. 2.
(A) Magnetic resonance image (MRI) on the 24th hospital day showed no more diffusion restriction, (B) but increased in amount of extra-axial fluid collection at left cerebral convexity. (C) One month later, follow-up MRI showed decreased in amount of extra-axial fluid collection.
piv-25-45f2.tif
Table 1.
The Result of Antimicrobial Susceptibility Test of Streptococcus agalactiae Isolated from the Patient
Antimicrobial agent MIC (µg/mL) Interpretation
Penicillin-G ≤0.12 S
Ampicillin ≤0.25 S
Ceftriaxone ≤0.12 S
Vancomycin 0.5 S
Erythromycin ≤0.12 S
Tetracycline ≥16 R
Levofloxacin ≥16 R
Clindamycin ≤0.25 S
Linezolid ≤2 S

Abbreviations: S, sensitive; R, resistant.

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