Group B Streptococcal Meningitis Associated With Otitis Media

Abstract

\s=b\A full-term infant of an appropriate size for gestational age was found to have meningitis due to Lancefield group B \ g = b \ \ x = r e q -\ hemolytic streptococci at 8 weeks of age. On admission, the baby had bulging tympanic membranes Lancefield group B \g=b\-hemolyticstreptococci were isolated from aspirate of the middle ear, supporting the importance of otitis media in the pathogenesis of late-onset Lancefield group B \g=b\-hemolyticstreptococcal meningitis.

Unspecific binding of group B streptococcal cocytolysin (CAMP factor) to immunoglobulins and its possible role in pathogenicity.

“…`Although Fry and Eng (2) were the first to describe three fatal group B postpartum infections and to point out the clinical importance of GBS in human infections, it was not until 1973 that GBS were firmly established as a major cause in perinatal infections (3)(4)(5)(6)(7)(8). Meanwhile a wealth of information has been accumulated and has been summarized in a number of review articles (9-11) .GBS have been isolated with increasing frequency from infants with early-and late-onset septicemia and meningitis (5, 12), but they also contributed to more infrequent infections in adults such as abortion, abscesses, bacteremia, impetigo, arthritis, septicemia, and urinary tract infections (2,5,8,(13)(14)(15)(16)(17)(18)(19)(20) .Besides the common group antigen, most strains of GBS share an extracellular protein first described in 1944 by Christie, Atkins, and Munch-Petersen, which accordingly was named CAMP factor (21). The CAMP factor causes lysis of red blood cells that contain at least 45 mol -% of sphingomyelin (22) and which have been exposed to Staphylococcus aureus #-toxin (sphingomyelinase) .…”

“…GBS have been isolated with increasing frequency from infants with early-and late-onset septicemia and meningitis (5, 12), but they also contributed to more infrequent infections in adults such as abortion, abscesses, bacteremia, impetigo, arthritis, septicemia, and urinary tract infections (2,5,8,(13)(14)(15)(16)(17)(18)(19)(20) .…”

Medical Treatment of Otitis Media: The Pediatrician's Point of View

“…The "high-risk" newborn under 6 weeks of age who has been on ventilators or has had a complicated perinatal course may be at increased risk for otitis media with gram-negative bacilli, such as Escherichia coli and Klebsiella as well as S. aureus and Group B Streptococcus (Bland, 1972;Ellis et al, 1976). Newborn infants also have a much higher incidence of meningitis and sepsis in association with acute otitis media (Tetzlaff et al, 1977).…”