Group B Streptococcal Meningitis in Adults: Report of Twelve Cases and Review

Abstract

Group B streptococcus (GBS) is the leading etiologic agent of bacterial meningitis and sepsis during the neonatal period, but it is an infrequent cause of meningitis in adults. We report 12 episodes of group B streptococcal meningitis in adults and review 52 cases reported in the literature. A total of 24 men and 40 women were included in the study; the mean age ({ SD) was 49.2 { 20.5 years (range, 17 -89 years). All the patients had cerebrospinal fluid cultures positive for GBS. Eighty-six percent of the patients had comorbid conditions, 50% had a distant focus of infection, and blood cultures yielded GBS for 78.7%. The overall case-fatality rate was 34.4% (22 patients). Factors associated with a poor outcome were advanced mean age ({ SD) (61.5 { 17.4 years vs. 42.8 { 19.2 years; P Å .0003) and the presence of complications on admission (P Å .0001). Seven percent of survivors had neurological sequelae. Group B streptococcal meningitis in adults has become increasingly frequent in recent years; it tends to occur in patients with severe underlying conditions and is associated with a high casefatality rate. Factors associated with a poor prognosis are advanced age and the occurrence of neurological and extraneurological complications.

TLR2 and Caspase-8 Are Essential for Group BStreptococcus-Induced Apoptosis in Microglia

“…The amount of NO 2 Ϫ was determined by using the colorimetric Griess reaction (SigmaAldrich), as described previously (34). The inducible NO synthase inhibitor aminoguanidine was also obtained from Sigma-Aldrich.…”

“…G roup B Streptococcus (GBS, 3 or Streptococcus agalactiae) accounts for ϳ50% of all cases of neonatal meningitis (1) and represents the third most frequent cause of bacterial meningitis overall (2,3). Bacterial meningitis is most commonly a manifestation of late-onset disease, which occurs after the first week of life and currently accounts for up to 50% of all neonatal cases of invasive GBS infections (4).…”

Diagnosis and Treatment of Tuberculous Meningitis

“…There are a cluster of circumstances that may explain this finding; elderly patients had taken out-ofhospital antibiotic therapy more frequently, and this, together with being older, makes the symptoms and signs of ABM subtler, as exemplified by the less frequent presence of symptoms and/or signs of ABM and skin lesions [15,29,[35][36][37][38], which may eventually lead to a diagnostic delay. But, above all, elderly patients had a cerebral CT performed more frequently, and this delayed the spinal tap and consequently the start of antibiotic therapy.…”

Meningitis bacteriana aguda por Streptococcus agalactiae en una mujer no embarazada asociada a una fístula de LCR: comunicación de un caso

“…La tasa de mortalidad de la MBA por S. agalactiae llega a 34% 1 y se postula que contribuyen a un peor pronóstico la edad avanzada y la presencia de complicaciones neurológicas o extra-neurológicas; pese a ello, se ha descrito que la gran mayoría de los pacientes que sobreviven a esta condición presentan una recuperación completa 1,7 . Figura 1.…”

“…L a meningitis bacteriana aguda (MBA) es una de las infecciones más frecuentes del sistema nervioso central (SNC) en adultos, siendo los agentes etiológicos más frecuentes Streptococcus pneumoniae y Neisseria meningitidis 1 . Sin embargo, en algunas ocasiones puede ser causada por otros microorganismos, tales como Mycobacterium tuberculosis, Listeria monocytogenes y Treponema pallidum.…”