Uncommon manifestations of neonatal group b Streptococcus infection: case report and literature review

Gregor Nosan ,Dominika Žugelj ,Darja Paro–Panjan

doi:10.22514/sv121.102016.23

Abstract

Streptococcus agalactiae, also called Group B Streptococcus (GBS), is a common path-ogen in the neonatal period that can cause early- and late-onset infections. The most common manifestations are bacteremia without an apparent focus of infection, pneumonia and meningitis. Additionally, GBS can rarely cause early- and late-onset infections with uncommon manifesta-tions. If they go unrecognized, they may lead to inappropriate treatment and in-creased neonatal morbidity and mortality. In this article, a case report of an infant with early-onset GBS bullous impetigo is presented together with a short review of other uncommon manifestations of GBS infection.

Highlights

Streptococcus agalactiae, called Group B Streptococcus (GBS), can cause earlyand late-onset infections in neonates
In late-onset infections, the most typical manifestations are bacteremia without any apparent focus, pneumonia, cellulitis, osteoarthritis and meningitis. Besides these frequent and well-recognized manifestations, there are rare, atypical manifestations of early- and late-onset GBS infections described in the literature
We present a case report of an infant with early-onset neonatal bullous impetigo caused by GBS and a short review of other uncommon GBS manifestations

Summary

INTRODUCTION

Streptococcus agalactiae, called Group B Streptococcus (GBS), can cause earlyand late-onset infections in neonates. The most common manifestations of early-onset infections are bacteremia without any apparent focus, pneumonia and meningitis. In late-onset infections, the most typical manifestations are bacteremia without any apparent focus, pneumonia, cellulitis, osteoarthritis and meningitis. Besides these frequent and well-recognized manifestations, there are rare, atypical manifestations of early- and late-onset GBS infections described in the literature. The fetal membranes were artificially ruptured and the amniotic fluid was milky. Scalp excoriations due to artificial rupture of the fetal membranes and a single large bulla, measuring 2 cm in diameter, filled with clear yellowish fluid, were all found parietally on the left side of the head. All samples taken (vesicle fluid, blood and CSF) were negative for HSV type 1 and 2 and varicella-zoster virus (polymerase chain reaction (PCR) method). The mother’s vaginal swab was negative for HSV type 1 and 2 (PCR method) and her serology tests showed only the presence of specific HSV type 1 IgG antibodies

Findings

DISCUSSION

CONCLUSION