Article in Japanese

A case of late-onset Group B Streptococcus meningitis complicated by multicystic encephalomalacia

Kumika Toyama^1）, Tomoko Maruyama^1）, Kana Ogawa^1）, Shinichi Katsuragi^1）, Yoshinori Satomura^1）, Ayako Negoro^1）, Hiroshi Nishiura^1）, Shigetoyo Kogaki^1）

Group B Streptococcus (GBS) meningitis is an invasive infectious disease in which delayed therapeutic intervention is associated with poor prognosis and sequelae. This study encountered a case of late-onset GBS meningitis complicated by multicystic encephalomalacia despite early initiation of antimicrobial treatment. The patient was a 25-day-old female infant. She presented with poor feeding and fever for 2 h, and pale complexion for 5 h before visiting a local hospital. The patient was transferred to this hospital via ambulance. Fever, tachycardia, peripheral circulatory failure and impaired consciousness were observed; sepsis screening was immediately performed and antimicrobials were administered subsequently. Based on the low levels of CSF glucose and positive GBS culture, the patient was diagnosed with GBS meningitis. Intensive respiratory and circulatory management was performed using antimicrobials. However, head contrast-enhanced magnetic resonance imaging on day 17 showed multicystic encephalomalacia and a subdural abscess. Antimicrobials (ampicillin) were administered for eight weeks. Neonatal fever and poor feeding require prompt diagnosis and antimicrobial treatment for severe infections, such as meningitis. The establishment of preventive methods against GBS infections, such as vaccines, is desirable because severe sequelae can occur despite early appropriate antimicrobial treatment after disease onset.

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1）Pediatrics & Neonatology ,Osaka General Medical Center

Key words	invasive GBS infection, GBS meningitis, late-onset, neonatal, multicystic encephalomalacia
Received	November 23, 2024
Accepted	February 20, 2025

37 (2)：191─197,2025