Early-Onset Meningitis with Group B Streptococcus: The Case of a Female Neonate with Brain Abscess in Iran

Group B streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis. Although late-onset GBS meningitis is the most common form of the disease, it may happen earlier, like just a few hours after birth, known as the early-onset. GBS meningitis is associated with 30% mortality rate among infants. Of those who stay alive, 25% of them will develop adverse neurological conditions. Herein, we report a case of early-onset GBS meningitis in a female infant with brain abscess.
A 10-hour old female was admitted to the neonatal intensive care unit (of the University of Tehran) for poor feeding, irritability, lethargy, and seizure. Sepsis work-up and lumbar puncture were performed. The treatment was started with vancomycin, cefotaxime and phenobarbital. The GBS was isolated from both blood and CSF cultures. A cranial sonography revealed intraparenchymal hemorrhage. The infant’s hospital course was complicated by recurrent and intractable seizures. The brain MRI of the patient showed micro-abscess. After six weeks of medical therapy, the patient was discharged from the hospital in a good condition. Neurological evaluations of the patient, conducted two and five months after her birth, showed normal results.
Neonates with GBS meningitis are prone to adverse neurological conditions, including brain abscess. Although GBS is a normal flora in the genitourinary tracts of 15 to 30% of women, routine screening and treatments of the GBS-positive women during their course of pregnancy could reduce such serious complications.