Unexpected Ventriculitis Complication of Neonatal Meningitis Caused by <i>Streptococcus gallolyticus</i> Subsp. <i>pasteurianus</i>: a Case Report

Abstract

Streptococcus gallolyticus subsp. pasteurianus, previously known as S. bovis biotype II 2, belongs to the S. bovis group and is an uncommon cause of neonatal bacterial meningitis (1). Over the last 2 decades, this pathogen is increasingly recognized as a cause of meningitis and bacteremia in young infants; however, its clinical significance has not been well established. Here, we report a case of neonatal meningitis that was unexpectedly complicated by ventriculitis due to this pathogen and review the relevant literature.A male infant was born by spontaneous vaginal delivery at term, weighing 3,680 g. Pregnancy and labor were uneventful. The patient developed fever (39 C) when he was 27 days old. Next day, he was admitted to the hospital with peripheral coldness, tachycardia, facial pallor, lethargy, and irritability. His anterior fontanel was not distended. Blood examination showed the following results: leukocyte count 17,380 mm 3 (64.5 segmented neutrophils, 18 bands); C-reactive protein 7.86 mg dL; procalcitonin 23.32 ng mL. The cerebrospinal fluid (CSF) was cloudy with leukocyte count at 7,909 mm 3 (97 polymorphonuclear cells), protein levels at 214 mg dL, and glucose levels at 1 mg dL (blood glucose 112 mg dL). Latex antigen tests were negative for Haemophilus influenzae type b, Neisseria meningitidis, Escherichia coli, group B Streptococcus (GBS) and

Streptococcus gallolyticus subsp. pasteurianus: un agente inusual ocasionando una infección común

“…Por lo general, el grupo de S. gallolyticus presenta un buen pronóstico en cuanto a su resolución y baja tasa de mortalidad 3 . La infección por este patógeno puede provocar complicaciones como neumonitis, ventriculitis, hemorragia intraventricular, derrame subdural o secuelas neurológicas tardías, como movimientos tónico-clónicos y fiebre 1,3,5,12,14 . En este caso, el paciente mostró una óptima respuesta al tratamiento proporcionado y, consecuentemente, no se documentaron secuelas.…”

Neonatal meningitis, endocarditis, and pneumonitis due to Streptococcus gallolyticus subsp. pasteurianus: a case report

“…As of 2008, there were a total of 30 neonatal cases of S. pasteurianus sepsis in the English literature [4]. Since then, an additional 3 cases have been reported in the USA and 18 cases reported in other countries [5–9]. This does not include one case report of neonatal S. bovis meningitis in the USA in 2012, in which the subspecies was not identified [10].…”

Primary pyogenic ventriculitis caused by Streptococcal pneumoniae in adults

“…Organism commonly reported in neonates are Streptococus bovis, S. gallolyticus , and S. intermedius . [567] In adults, primary ventriculitis caused by Nisseria meningitis ,[38] Streptococus acidominicus ,[9] and S. agalactiae [10] has been reported.…”