Article in Japanese

Acute neonatal suppurative parotitis caused by group B streptococcus

Maria YOSHIMI ^1）, Taishi NADA^1）, Sho NAKAYAMA^1）, Hiroyuki SHIMIZU^2）, Mari IWAMOTO^1）

Neonatal suppurative parotitis (NSP) is a rare disease characterized by parotid swelling and local inflammatory signs and few case reports or case series have been reported. The most common pathogen is Staphylococcus aureus although other bacteria have been implicated. This paper describes the case of a 34-day-old girl with late-onset group B streptococcus (GBS). Redness and swelling of her neck appeared and she was transferred to this hospital by ambulance. A 38 ℃ fever was recorded in the ambulance and she was in a state of compensatory shock on arrival at the emergency department. She was admitted to this department after treatment for compensatory shock. Her birth weight was 1,834 g and she was admitted to the Neonatal Intensive Care Unit (NICU) in this hospital up to fourteen days before admission. Laboratory findings showed elevated C reactive protein of 1.4 mg/dL and elevated procalcitonin of 17.6 ng/mL with normal serum amylase of 5 U/L. Contrast-enhanced computed tomography (CT) showed swelling of the right parotid gland and GBS was isolated from blood culture. Taken together, her illness was diagnosed as purulent parotitis associated with GBS. The patient was treated successfully with 3 weeks of antibiotics. GBS bacteremia was present in all previously reported cases of NSP caused by GBS. However, elevated serum amylase in purulent parotitis is observed rarely from the neonatal to early infancy period. Purulent parotitis should be included in the differential diagnosis of neonatal cervical swelling even in the absence of increased serum amylase.

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1）Department of Pediatrics, Saiseikai Yokohamashi Tobu Hospital
2）Department of Clinical Laboratory Medicine, Fujisawa City Hospital

Key words	suppurative parotitis，group B streptococcus，infant，late-onset，bacteremia
Received	December 22, 2020
Accepted	June 6, 2021

33 (3)：250─256,2021