Pediatr Infect Vaccine.  2019 Dec;26(3):194-198. 10.14776/piv.2019.26.e17.

A Case of Neonatal Meningitis Caused by Streptococcus dysgalactiae subspecies dysgalactiae and Herpes Simplex Virus

• Im G
• Park Y
• Kim M
• Kim KH
• Kim SY
• Chung SY

• KMID: 2466464
• DOI: http://doi.org/10.14776/piv.2019.26.e17

Abstract

Streptococcus dysgalactiae has two main subspecies: S. dysgalactiae subsp. equisimilis (SDSE) and S. dysgalactiae subsp. dysgalactiae (SDSD). SDSE often colonizes and causes infections in humans; however, SDSD is an animal pathogen which often causes pyogenic infection in domestic animals. We present a case of meningitis with SDSD and herpes simplex virus in a 22-day-old newborn baby who had no exposure to animals.

Keyword

Streptococcal infection; Newborn; Meningitis; Bacteria

MeSH Terms

Animals
Animals, Domestic
Bacteria
Colon
Herpes Simplex*
Humans
Infant, Newborn
Meningitis*
Simplexvirus*
Streptococcal Infections
Streptococcus*

Figure

• 

  Fig. 1 Brain diffusion-weighted magnetic resonance imaging scan of 23-day-old baby at hospital day 2. Focal seizures occurred on the second hospital day. The scan revealed multifocal diffusion restricted lesions at left frontotemporoparietal lobes (A, B, arrow).

• 

  Fig. 2 Brain magnetic resonance diffusion scan at 3 months of age, 2 months after treatment. It showed old infarcts with more cystic changes at left frontotemporoparietal lobes (arrow).

Reference

1. Watanabe S, Takemoto N, Ogura K, Miyoshi-Akiyama T. Severe invasive streptococcal infection by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis. Microbiol Immunol. 2016; 60:1–9.

2. Chennapragada SS, Ramphul K, Barnett BJ, Mejias SG, Lohana P. A rare case of Streptococcus dysgalactiae subsp. dysgalactiae human zoonotic infection. Cureus. 2018; 10:e2901.

3. Park MJ, Eun IS, Jung CY, Ko YC, Kim YJ, Kim CK, et al. Streptococcus dysgalactiae subspecies dysgalactiae infection after total knee arthroplasty: a case report. Knee Surg Relat Res. 2012; 24:120–123.

4. Shim GH, Kim SD, Kim HS, Kim ES, Lee HJ, Lee JA, et al. Trends in epidemiology of neonatal sepsis in a tertiary center in Korea: a 26-year longitudinal analysis, 1980–2005. J Korean Med Sci. 2011; 26:284–289.

5. Cortese F, Scicchitano P, Gesualdo M, Filaninno A, De Giorgi E, Schettini F, et al. Early and late infections in newborns: where do we stand? a review. Pediatr Neonatol. 2016; 57:265–273.

6. Facklam R. What happened to the streptococci: overview of taxonomic and nomenclature changes. Clin Microbiol Rev. 2002; 15:613–630.

7. Koh TH, Sng LH, Yuen SM, Thomas CK, Tan PL, Tan SH, et al. Streptococcal cellulitis following preparation of fresh raw seafood. Zoonoses Public Health. 2009; 56:206–208.

8. Rato MG, Nerlich A, Bergmann R, Bexiga R, Nunes SF, Vilela CL, et al. Virulence gene pool detected in bovine group C Streptococcus dysgalactiae subsp. dysgalactiae isolates by use of a group A S. pyogenes virulence microarray. J Clin Microbiol. 2011; 49:2470–2479.

9. Roma-Rodrigues C, Alves-Barroco C, Raposo LR, Costa MN, Fortunato E, Baptista PV, et al. Infection of human keratinocytes by Streptococcus dysgalactiae subspecies dysgalactiae isolated from milk of the bovine udder. Microbes Infect. 2016; 18:290–293.

10. Takahashi T, Ubukata K, Watanabe H. Invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis: characteristics of strains and clinical features. J Infect Chemother. 2011; 17:1–10.

11. Rantala S. Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection. Eur J Clin Microbiol Infect Dis. 2014; 33:1303–1310.

12. Ericsdotter AC, Brink M, Studahl M, Bengnér M. Reactivation of herpes simplex type 1 in pneumococcal meningitis. J Clin Virol. 2015; 66:100–102.

13. Nožić D, Živković N, Ćirković S, Jovanović D, Tomanović B, Antić B. Meningoencephalitis in splenectomized patient caused by concurrent Streptococcus pneumoniae and Herpes simplex virus infection. Acta Med Acad. 2007; 36:35–37.

14. Ali J, Walsh H, Sanapala S, Syed N. Concurrent meningococcal and herpes simplex infection in a non-immunocompromised child. BMJ Case Rep. 2014; 2014:bcr2013203395.