Invasive Streptococcus agalactiae Disease With Meningitis and Septic Arthritis in a Non-pregnant Patient

Abstract

Streptococcus agalactiae is a common constituent of the human flora. However, infection in immunocompetent adults is uncommon and the involvement of the central nervous system (CNS) or development of septic arthritis are exceedingly rare and by our knowledge, were only described simultaneously once in a retrospective study. We present the case of a 66-year-old woman with S. agalactiae bacteremia presenting meningitis and septic arthritis of the left shoulder. The patient presented to the emergency department with altered mental status and fever. Lumbar puncture revealed cerebral spine fluid (CSF) pleocytosis and elevated proteins. Blood and CSF cultures identified the presence of a susceptible strain of S. agalactiae . During hospitalization, the patient complained of left shoulder pain, enabling the identification of articular fluid collections, which were drained confirming their infectious origin. Colic ulcers were found to be the starting point of this infection with posterior involvement of the CNS and the development of septic arthritis by hematogenous dissemination.

A Case of Dual Septic Foci in Both the Joint and Pleural Cavity Caused by Streptococcus agalactiae

“…Its polysaccharide capsule is characterized by the Lancefield group B antigen; it is one of the main virulence factors associated with the bacterium's invasive capacity [ 8 ]. Infections with GBS are more common in pregnant women and newborns [ 2 ]. GBS is part of the normal flora in healthy adults and acts as an opportunistic pathogen, exceptionally transitioning from asymptomatic carriage to noninvasive or invasive disease.…”

“…Streptococcus agalactiae , commonly known as Lancefield Group B Streptococcus (GBS), is a typically harmless bacterium present in the genital tract of healthy women, as well as in the gastrointestinal and urinary tracts of healthy adults [ 1 ]. Although GBS infections are more frequently encountered in newborns and can manifest severely, causing conditions like bacteremia and meningitis [ 2 ], instances of this opportunistic pathogen causing bacteremia in elderly individuals or adults with compromised immune systems, such as those with diabetes or cancer, have been documented [ 2 , 3 ]. Nevertheless, its association with infectious pleurisy or septic arthritis is rare [ 4 , 5 ], with no reported cases of both conditions being attributed to GBS simultaneously.…”