Penicillin-Resistant Streptococcus mitis as a Cause of Septicemia with Meningitis in Febrile Neutropenic Children

Abstract

Physicians caring for patients who are neutropenic and febrile need to be aware of the risk of meningitis occurring with S. mitis sepsis. Early treatment with high dosages of vancomycin (60 mg/kg/day) and an attempt to limit the duration of neutropenia are important factors in the outcome of such patients.

Group B Streptococcus Meningitis in an HIV-Positive Adult: Case Report and Review

“…In our case, the patient was not an active drug user, but was severely immunocompromised, with a CD4 count of only 173/mm 3 , as was the patient in the study of Almirante et al (4). In 3 of 4 cases, group B streptococci grew in CSF and blood cultures.…”

“…The vital long-term prognosis does thus not depend on the meningitis itself, but on the degree of immunodeficiency and on such associated infections as, for example, chronic B hepatitis in the case of Almirante et al (4). (1).…”

“…Cases associated with HIV infection seem to be rare; only 3 cases have been reported so far (3)(4)(5).…”

Atypical presentation of thoracic spondylodiscitis caused byStreptococcus mitis

“…To the best of our knowledge, this is the first reported case of atypical presentation of S. mitis thoracic spondylodiscitis without evidence of infectious endocarditis. S. mitis has been isolated from the sinuses of patients with chronic inflamed maxillary sinusitis25 and sinusitis has been related to systemic S. mitis bacteraemia and meningitis 26 27. Although the patient had chronic sinusitis, we did not obtain the sinus culture because the treatment had started based on the result of bone culture.…”

Management of the Febrile Neutropenic Patient: A Consensus Conference

“…The appearance and rapid spread of strains of Enterococcus species with high-level resistance to aminoglycosides has aroused concern, because they can result in more-severe disease with a worse prognosis [44][45][46][47]. aHemolytic streptococci are acquiring a high degree of resistance [48] and cause disease with a severe clinical presentation and with high mortality among febrile neutropenic patients [49].…”