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Streptococcus gallolyticus subspecies pasteurianus meningitis in an infant: a case report and literature review

Warunee Punpanich1, Anurak Munsrichoom, Surang Dejsirilert

  • 1Department of Pediatrics, Queen Sirikit National Institute of ChildHealth, Bangkok, Thailand. waruneep@gmail.com

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|February 9, 2013
PubMed

Insights

A 6-week-old infant with Streptococcus gallolyticus subspecies pasteurianus meningitis and bacteremia showed delayed recovery. Combination therapy with vancomycin and penicillin G led to a full recovery.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Streptococcus gallolyticus subspecies pasteurianus (formerly Streptococcus bovis biotype 11.2) is an uncommon cause of meningitis and bacteremia in infants.
  • Beta-lactam antibiotics are typically effective against this pathogen.

Observation:

  • A 6-week-old male infant presented with meningitis and concurrent bacteremia.
  • The causative pathogen, Streptococcus gallolyticus subspecies pasteurianus, demonstrated susceptibility to all tested beta-lactam antibiotics.
  • Despite initial treatment with multiple beta-lactam antibiotics, the infant experienced delayed defervescence and suboptimal clinical improvement.

Findings:

  • Combination therapy utilizing vancomycin and penicillin G was initiated due to the lack of satisfactory response to beta-lactam monotherapy.
  • The infant completed a 2-week course of combination antibiotic therapy.
  • The patient recovered uneventfully from meningitis and bacteremia.

Implications:

  • This case highlights the potential for Streptococcus gallolyticus subspecies pasteurianus to cause severe invasive infections in infants.
  • It underscores the importance of considering combination therapy when initial beta-lactam treatment proves insufficient, even in cases of documented susceptibility.
  • Effective management strategies are crucial for favorable outcomes in infant meningitis and bacteremia.

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