Neonatal group A streptococcal meningitis: a case report and review of the literature

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Abstract

Introduction

Group A streptococcus is a rare cause of neonatal meningitis. A review of MEDLINE database since1966 revealed only 15 documented cases of group A streptococcal meningitis in neonates.

Case report

A previously healthy 28 days old male neonate presented with a history of irritability, fever, and focal seizures. Cerebrospinal fluid analysis and culture confirmed the diagnosis of group A streptococcal meningitis. The clinical course was complicated by the development of brain abscess. The patient made full recovery following a surgical drainage of the abscess and a 6-week total course of antibiotics.

Conclusion

Although it is an uncommon organism, clinician should always consider group A streptococcal infection and its potential complications in the differential diagnosis and management of neonatal meningitis.

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Most cited references 14

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Neonatal invasive group A streptococcal disease: case report and review of the literature.

Dominic Berlingieri, John Protic, Isao Miyairi … (2004)

We present a fatal case of neonatal invasive group A streptococcal disease and review of the literature. Twenty-four cases were early onset disease and were associated with concurrent maternal infection, respiratory distress, pneumonia, toxic shock-like syndrome and serotype M1. Fifteen cases were late onset disease associated with soft tissue infections and meningitis. Maternal carriage was identified as an important factor in neonatal group A streptococcal disease.

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Severe neonatal group A streptococcal disease.

Eduard Fleer, C. Krediet, Malgorzata A. Verboon-Maciolek … (2000)

Since the mid-1980s, an increase in incidence of invasive disease caused by group A streptococci has been noted amongst adults and children; however, neonatal disease is still rare. Between 1979 and 1998, seven neonates with severe group A streptococcal disease were admitted to our neonatal intensive care unit. The clinical presentation, treatment and outcome are described. In three cases of early-onset disease vertical transmission was documented. Because the incidence of group A streptococcal disease in the general population seems to have increased over the last two decades, we should be aware of the possibility and particularly the severity of group A streptococcal disease in the neonatal period.

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Invasive disease due to group A beta-hemolytic streptococci: continued occurrence in children in North Carolina.

L B Givner (1998)

We have previously reported a significant increase beginning in the late 1980s in the incidence of invasive disease due to group A beta-hemolytic streptococci (GABS) in children admitted to our hospital. To determine subsequent trends in epidemiology, we have continued to monitor cases. We prospectively monitored cases of invasive disease due to GABS at Brenner Children's Hospital during the 5 1/2 years (July 1, 1990, to December 31, 1995) since our last report. Twenty-five patients had GABS isolated from normally sterile sites. Their presentations were varied. One patient had necrotizing fasciitis and one had toxic shock-like syndrome. The one death was that of a newborn infant with sepsis and meningitis. The proportion of GABS infections associated with varicella was significantly greater during this period (7/25, 28%) than during the period 1983 to 1990 (1/22, 5%). Isolates were available tor study from 24 patients. Serotypes were M1 (4), M3 (4), M6 (2), M12 (3), M22 (3), M75 (1) and M-nontypeable (7). The number of cases of invasive disease seen annually from 1983 through 1995 also is reviewed. The resurgence of invasive disease due to GABS in children noted in the late 1980s continues through the first half of the 1990s. The clinical manifestations are varied as are the causative M-types. As almost one third of cases in this series were associated with varicella infection, widespread use of the varicella vaccine may lead to a decrease in the incidence of invasive GABS disease.

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Author and article information

Journal

Journal ID (nlm-ta): Cases J

Title: Cases Journal

Publisher: BioMed Central

ISSN (Electronic): 1757-1626

Publication date Collection: 2008

Publication date (Electronic): 18 August 2008

Volume: 1

Page: 108

Affiliations

[1 ]Department of Pediatrics, King Fahd Hospital of the University, Alkhobar, Saudi Arabia

Article

Publisher ID: 1757-1626-1-108

DOI: 10.1186/1757-1626-1-108

PMC ID: 2531175

PubMed ID: 18710558

SO-VID: 0610f3fe-7a49-450f-a19d-ddb60a03f1b0

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Neonatal group A streptococcal meningitis: a case report and review of the literature

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Abstract

Introduction

Case report

Conclusion

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Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 14

Neonatal invasive group A streptococcal disease: case report and review of the literature.

Severe neonatal group A streptococcal disease.

Invasive disease due to group A beta-hemolytic streptococci: continued occurrence in children in North Carolina.

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