Late onset Group B Streptococcus meningitis in an infant in Iran; a case report

Group B Streptococcus (GBS) is a leading infectious agent in neonatal mortality, which has been well studied in high-income countries (HICs), but in low and middle-income countries (e.g. Iran) has not been well studied. We present an infant with late onset GBS meningitis in Iran, whose source of infection in the patient was unclear.Case presentation:A 14-day-old male infant was referred to our emergency ward (Imam Ali Karaj Medical Center, Iran) due to fatigue and lethargy. All examinations for the patient were normal. Subsequently, due to the presence of fever, fatigue and lethargy, the patient was admitted and examined for sepsis. After 8 days, the patient s fever persisted despite treatment. Cerebrospinal fluid cultures showed GBS growth with sensitivity to ampicillin sulbactam, isoniazid, ceftriaxone, penicillin G, and vancomycin, which was confirmed by PCR. Subsequently, ampicillin sulbactam was added to the treatment, and the patient was discharged after 14 days of antibiotic treatment with meningitis doses with relief of symptoms and fever (48 hours) with no problem in follow-up for 2 weeks.Discussion and conclusion:Previous studies have shown that the pathogenesis of LOD is less understood. Nosocomial GBS transmission, on the other hand, have been prevalent in health care workers for decades, when mothers and their infants typically stay in hospital for at least one week But in our case, the patient and his mother did not have a long hospital stay. Previous studies have also reported the onset of GBS-induced meningitis following otitis media, but ENT examinations were normal in our patient. Although infrequently, GBS-induced late onset meningitis occurs without a definite source of infection as in our patient, so in late-onset meningitis in neonates with no risk factor for GBS, this pathogen must be considered.

Keywords:

GBS , late onset meningitis , neonate