Pediatr Infect Vaccine.  2018 Apr;25(1):45-49. 10.14776/piv.2018.25.1.45.

Late-Onset Group B Streptococcal Meningitis Complicated with Extensive Cerebral Infarction

• Cho MS
• Kim Y
• Cho HK
• Choi SH

• KMID: 2438753
• DOI: http://doi.org/10.14776/piv.2018.25.1.45

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.

Keyword

Streptococcus agalactiae; Neonatal sepsis; Meningitis; Cerebral infarction

MeSH Terms

Bacteremia
Blindness, Cortical
Cerebral Infarction*
Female
Humans
Meningitis*
Mortality
Serogroup
Streptococcus
Streptococcus agalactiae
Survivors

Figure

• 

  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.

• 

  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.

Reference

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