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Abstract
Ventriculitis is a well known feature of gram negative meningitis but has not been documented as a serious complication of gram positive central nervous system infections. This report describes five patients with GBS meningitis and ventriculitis. In each case ventriculitis was shown either by ventricular cerebrospinal fluid (CSF) pleocytosis, positive GBS counter immuno-electrophoresis, or positive culture for GBS. The lumbar CSF was sterile with no pleocytosis in two of the five patients despite concomitant abnormal ventricular fluid. Computerized axial tomography was of great value diagnostically and in management of increasing head size in these patients. Four of the five infants presented after one month of age and all had marked hy-drocephalus. Three of the five infants were initially thought to have uncomplicated hydrocephalus and only after diagnostic ventricular puncture was ventriculitis and/or meningitis suspected. All five patients had significant intellectual and motor neurological sequelae subsequent to their infection. Ventriculitis appears to be a common and significant complication of GBS meningitis. Ventriculitis caused by GBS may resemble uncomplicated hydrocephalus in its presentation, emphasizing the need to examine all CSF carefully before shunting procedures are pursued.
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