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Group B streptococcus: an unusual cause of severe peritonitis in young children treated with continuous ambulatory
C H Schröder1, M C de Jong, L A Monnens
1Department of Pediatrics, St. Radboud University Hospital, Nijmegen, The Netherlands.
Insights
Peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients is rarely caused by beta-hemolytic streptococci. Two children experienced severe peritonitis from group B streptococci, similar to neonatal septicemia, possibly due to IgG2 deficiency.
Area of Science:
- Pediatrics
- Nephrology
- Infectious Diseases
Background:
- Peritonitis is a serious complication in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- Beta-hemolytic streptococci are an uncommon cause of peritonitis in CAPD patients.
- Group B beta-hemolytic streptococci are typically associated with neonatal infections.
Observation:
- This report details two pediatric cases of severe peritonitis caused by group B beta-hemolytic streptococci in young children on CAPD.
- The clinical presentation and severity of the peritonitis mimicked neonatal streptococcal septicemia.
- The patients were aged 15 months and 5 years.
Findings:
- The severe peritonitis observed in these pediatric CAPD patients was attributed to group B beta-hemolytic streptococci.
- The disease course strongly resembled neonatal streptococcal septicemia, suggesting a shared pathophysiological mechanism.
- A potential contributing factor identified is IgG2 deficiency, known in neonates and established in children.
Implications:
- These findings highlight the potential for severe infections from less common pathogens in pediatric CAPD.
- The role of IgG2 deficiency in severe streptococcal peritonitis in young CAPD patients warrants further investigation.
- This underscores the importance of considering specific pathogens and host immune factors in managing peritonitis in pediatric CAPD.
Abstract:
Peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients is only rarely caused by beta-hemolytical streptococci species. We describe two young children, aged 15 months and 5 years, respectively, who presented an unusually severe course of peritonitis due to group B beta-hemolytical streptococci. This course of the disease showed a strong similarity with neonatal streptococcal septicemia. In neonates, IgG2 deficiency is thought to be partly responsible for the severity of this condition. This may also be true for young children treated with CAPD, since IgG2 deficiency has been established for children.