Group B Streptococcal Meningitis: A Description of Six Case Reports

Group B Streptococcus (GBS) is considered the leading bacterial cause of neonatal infections and meningitis is the most serious manifestation. Its clinical manifestations are usually non-specific and its signs and symptoms may be subtle, unspecific, vague, atypical or absent. We report six clinical cases of GBS meningitis with early onset in three infants (first week of life) and late onset (after 1 month of life) in the remaining three. Prenatal GBS screening, performed on four infants, resulted positive only in one case. Cerebral ultrasonography showed high sensitivity in detecting early meningeal involvement confirmed by MRI in all infants. Our study describes the clinical characteristics, antibiotic sensitivity and outcome of the six cases. The results of our analysis emphasize the severity of GBS meningitis and show that cerebrovascular involvement is a common but poorly studied pathologic process in GBS meningitis. In addition, cranial ultrasonography plays an important role in detecting infarctions, cerebritis, hemorrhages or abscesses and in monitoring complications. Neonates with GBS meningitis are prone to adverse outcomes or sequelae. Mortality in GBS meningitis approaches 30% and neurologic sequelae are present in 25% of cases. Int J Clin Pediatr. 2015;4(1):127-136 doi: http://dx.doi.org/10.14740/ijcp179w