Abstract
BACKGROUND: Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality. About 15% of women are carriers of GBS. Usually, they are asymptomatic. CASES: We describe two patients with symptomatic vaginitis for which no apparent cause was found. Both patients were heavily colonized with GBS. After antibiotic treatment, both became asymptomatic and culture negative, but after recolonization with GBS, symptoms resumed. This phenomenon was repeatedly observed. After emergence of resistance to antibiotics, local application of chlorhexidine appeared to be the only useful treatment. CONCLUSION: We hypothesize that GBS-vaginitis may be a possible disease entity. Although at present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients.
Highlights
Maternal cervicovaginal colonization with Lancefield group B streptococci (GBS) is an important risk factor for neonatal morbidity and mortality
We hypothesize that GBS-vaginitis may be a possible disease entity
In the papers noted, there was no statement about GBS being the cause of the vaginitis or just a cofactor
Summary
We hypothesize that GBS-vaginitis may be a possible disease entity. At present it is not clear why some patients become symptomatic, we speculate that the immunologic response is somehow selectively hampered in such patients. Infections that occur before the seventh day of lifemsocalled early onset infectionsmare usually caused by vertical transmission. One study showed that in patients with purulent vaginal discharge the prevalence of GBS was increased. In the papers noted, there was no statement about GBS being the cause of the vaginitis or just a cofactor. We here describe two patients with vaginitis presumably caused by GBS, a condition that, to our knowledge, has not been reported before
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