Abstract
BackgroundStreptococcus agalactiae (Group B Streptococcus) is recognized as the etiologic agent of newborn and infant meningitis, aged up to 90 days, starting from the colonization of the maternal genital or gastrointestinal tract, but it is rarely responsible for meningitis in old infants.Case presentationWe present the case of a 9 month-old infant diagnosed with S. agalactiae meningoencephalitis associated with chronic gastroesophageal reflux disease treated with a proton pump inhibitor (PPI).ConclusionThe use of a PPI is a risk factor for ultra-late onset of Group B Streptococcus meningitis. The use of PPI in infants should be closely monitored in the light of changes in the gut microbiota, in the oropharyngeal and of the respiratory tract colonization, potentially with pathogenic flora.
Highlights
Streptococcus agalactiae (Group B Streptococcus) is recognized as the etiologic agent of newborn and infant meningitis, aged up to 90 days, starting from the colonization of the maternal genital or gastrointestinal tract, but it is rarely responsible for meningitis in old infants
Streptococcus agalactiae (Group B Streptococcus, group B Streptococcus (GBS)) is a gram positive encapsulated coccus which has the ability to invade host tissues and the host defense mechanisms, to cause systemic infections such as sepsis, pneumonia, and due to its ability of crossing the blood brain barrier, it is responsible for meningitis, being the leader in the etiology of neonatal meningitis [1]
Gastroesophageal reflux disease associated with pump inhibitor (PPI) use, was in our opinion, the determinant factor of the upper digestive tract colonization with GBS, which was associated with leukopenia induced by PPIs, factor that is involved in bacterial clearance in the bacteremia stage
Summary
Streptococcus agalactiae (Group B Streptococcus) is recognized as the etiologic agent of newborn and infant meningitis, aged up to 90 days, starting from the colonization of the maternal genital or gastrointestinal tract, but it is rarely responsible for meningitis in old infants. * Correspondence: victoriabirlutiu@yahoo.com 1Lucian Blaga University of Sibiu, Faculty of Medicine; Infectious Diseases Clinic, Academic Emergency Hospital Sibiu, Alba-Iulia Str. No.79 23/8, 550052 Romania Full list of author information is available at the end of the article occurs as early-onset disease (EoD), within 7 days postpartum, by infection in utero, by placenta infection.
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