Streptococcus agalactiae meningoencephalitis associated with gastroesophageal reflux disease and chronic proton pump inhibitors use, in a 9 month-old infant: a case report

Abstract

BackgroundStreptococcus agalactiae (Group B Streptococcus) is recognized as the etiologic agent of newborn and infant meningitis, aged up to 90 days, starting from the colonization of the maternal genital or gastrointestinal tract, but it is rarely responsible for meningitis in old infants.Case presentationWe present the case of a 9 month-old infant diagnosed with S. agalactiae meningoencephalitis associated with chronic gastroesophageal reflux disease treated with a proton pump inhibitor (PPI).ConclusionThe use of a PPI is a risk factor for ultra-late onset of Group B Streptococcus meningitis. The use of PPI in infants should be closely monitored in the light of changes in the gut microbiota, in the oropharyngeal and of the respiratory tract colonization, potentially with pathogenic flora.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-0995-0) contains supplementary material, which is available to authorized users.

Simultaneous Presentation of B-Acute Lymphoblastic Leukemia and Streptococcus agalactiae Meningitis in a 3-Year-old Girl

“…8 Individual cases of GBS meningitis in older children have been reported to occur in previously healthy children aged 5 years, 14 years, and in a 9-month-old infant on protonpump inhibitor therapy. [9][10][11] Other cases of invasive GBS disease in older children have been reported as right femoral osteomyelitis in a 16-year-old male with a history of right knee fibroma and cellulitis and bacteremia in a 4-year-old with steroid-responsive nephrotic syndrome. 12 Ischemic brain injury has been documented in ~10% of cases of perinatal and childhood meningitis.…”

“…One retrospective study showed an increased incidence of GBS bacteremia in children and adults over a 4-year period in Qatar, including 10 cases in patients aged 5 to 24 years 8 . Individual cases of GBS meningitis in older children have been reported to occur in previously healthy children aged 5 years, 14 years, and in a 9-month-old infant on proton-pump inhibitor therapy 9–11 . Other cases of invasive GBS disease in older children have been reported as right femoral osteomyelitis in a 16-year-old male with a history of right knee fibroma and cellulitis and bacteremia in a 4-year-old with steroid-responsive nephrotic syndrome 12 …”

Development of a droplet digital PCR method for detection of Streptococcus agalactiae

“…Streptococcus agalactiae (Group B Streptococcus, GBS) is a facultative anaerobic gram-positive opportunistic pathogen, which colonizes the gastrointestinal and genitourinary tract of approximately 30% of the healthy adults [1]. Moreover, infection with GBS is the main cause of pneumonia, septicemia and meningitis in neonates, and is especially responsible for the high morbidity rate of pregnant women [2][3][4]. So far, detection of Streptococcus agalactiae varies from culture-based methods to novel molecular tools [5,6].…”