Korean J Pediatr.  2015 Jan;58(1):33-36. 10.3345/kjp.2015.58.1.33.

Neonatal invasive Streptococcus gallolyticus subsp. pasteurianus infection with delayed central nervous system complications

• Park JW
• Eun SH
• Kim EC
• Seong MW
• Kim YK

• KMID: 2284465
• DOI: http://doi.org/10.3345/kjp.2015.58.1.33

Abstract

Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies have reported meningitis and septicemia in infants. Here, we describe a case of bacteremia and meningitis due to Streptococcus gallolyticus subsp. pasteurianus with a delayed CNS complication in an infant. A 28-day-old male infant was admitted to the hospital with a 1-day history of fever. Cultures of blood, cerebrospinal fluid, and urine showed the presence of S. bovis group strain-S. gallolyticus subsp. pasteurianus. He was discharged after 21 days of intravenous ampicillin and cefotaxime administration. Two weeks later, he was readmitted with a fever and short episodes of tonic-clonic movements. Brain magnetic resonance imaging showed marked bilateral frontal subdural effusion. He was discharged after 31 days of antibiotic therapy, and no neurological sequelae were observed at the 9-month follow-up. In conclusion, we present a rare case of neonatal S. gallolyticus subsp. pasteurianus infection causing urinary tract infection, septicemia, meningitis, and delayed CNS complications. This case emphasizes the need for physicians to be aware of S. bovis infection in infants.

Keyword

Streptococcus bovis; Bacteremia; Infant; Streptococcal infection; Sepsis

MeSH Terms

Adult
Ampicillin
Bacteremia
Brain
Cefotaxime
Central Nervous System*
Cerebrospinal Fluid
Endocarditis
Fever
Follow-Up Studies
Humans
Infant
Infant, Newborn
Korea
Magnetic Resonance Imaging
Male
Meningitis
Sepsis
Streptococcal Infections
Streptococcus bovis
Streptococcus*
Subdural Effusion
Urinary Tract Infections
Ampicillin
Cefotaxime