The first case of recurrent ultra late onset group B streptococcal sepsis in a 3-year-old child

Abstract

Group B streptococcus (GBS) is a commonly recognized cause of sepsis and meningitis in neonatal and young infants. Invasive GBS infection is classified into early onset GBS disease (EOD, day 0–6), late onset GBS disease (LOD, day 7–89) and ultra late onset GBS disease (ULOD, after 3 months of age). ULOD is uncommon and recurrence is especially rare. We present the first recurrent case of ULOD GBS sepsis in 3-year-old girl with a past medical history of hydrops fetalis and thoracic congenital lymphatic dysplasia. The first episode presented as sepsis at 2 years 8 months of age. The second episode occurred as sepsis with encephalopathy at 3 years 1 months of age. During each episode, the patient was treated using intravenous antimicrobials and her condition improved. Serotype examination was not performed in the first episode, but GBS type V was serotyped in the second episode. ULOD over 1 year of age is quite rare and may recur.

Enhanced identification of Group B streptococcus in infants with suspected meningitis in Ethiopia

“…The invasive GBS infections can be categorized into early-onset disease (EOD), late-onset disease (LOD), and rarely as ultra-late onset disease (ULOD). The EOD occurs within the first six days of life while the LOD and the ULOD occurs from 7 up to 89 days, and after 3 months of age respectively [ 6 , 7 ]. Recently, GBS has emerged as a leading cause of meningitis in neonates and young infants, resulting in high mortality [ 8 ].…”

Invasive Group B Streptococcal Disease In Childhood

“…7 Other reports include a child with steroid-responsive nephrotic syndrome 8 and recurrent invasive GBS disease in a child with thoracic congenital lymphocytic dysplasia. 9 Human immunodeficiency virus infection has been associated with GBS disease but usually presents earlier than 1 year. 4,10 Such reports support evaluation of components of the immune system that modulate host defense in children with invasive GBS disease.…”

Fatal case of hemophagocytic lymphohistiocytosis associated with group B streptococcus sepsis

“…[ 15 ] GBS infection is rare in children over 1 year of age. [ 16 – 18 ] Phares et al [ 17 ] reported that the incidence of invasive GBS infection in the United States was 0.22 per 100,000 in children aged 1 to 14 years compared with 7.2 per 100,000 in the total population. Additionally, 40% of GBS-infected patients aged 1 to 14 years had at least 1 underlying disease, such as a neurologic disorder, immunosuppression, asthma, malignancy, or renal disease.…”