Recurrent Group B Streptococcus Septicemia Secondary to Portal Hypertensive Colopathy

Abstract

BackgroundGroup B streptococcal infections (GBSs) in nonpregnant adults have become an increasingly recognized entity. Bacteremia without focus has consistently been demonstrated as the second leading cause of infection. Recurrent bacteremia, however, remains a significantly rarer phenomenon, and underlying mechanisms and risk factors are poorly elucidated in the literature.Case ReportWe report the first case of 3 independent episodes Streptococcus agalactiae bacteremia without focus, in 56-year-old woman with Child-Pugh B cirrhosis and the uncommon finding of portal hypertensive colopathy.ResultsWe propose bowel hemorrhage secondary to portal hypertensive colopathy, facilitated recurrent bacterial translocation and blood stream infection in this immunocompromised host, presenting as recurrent bacteremia without focus. We discuss the disease epidemiology of GBS infections, antibiotic sensitivity, and risk factors for infection relating to this theory in a literature review.ConclusionsPortal hypertensive colopathy in liver cirrhosis may contribute to underlying risk for recurrent GBS bacteremia without focus that necessitates prolonged penicillin class antibiotic therapy.