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Streptococcus agalactiae septicemia in a patient with diabetes and hepatic cirrhosis

Renan Pedroso Batista1, Cristiane Rúbia Ferreira2

  • 1Department of Pathology - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .

Autopsy & Case Reports
|February 20, 2016
PubMed

Insights

Streptococcus agalactiae, a common cause of neonatal infections, can cause severe invasive disease in non-pregnant adults. This case highlights a fatal outcome in a middle-aged man with underlying conditions, emphasizing the need to consider this pathogen in invasive infections.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Critical Care Medicine

Background:

  • Streptococcus agalactiae (Group B Streptococcus) is a significant pathogen in pregnant women and neonates.
  • Invasive infections by S. agalactiae are increasing in non-pregnant adults, particularly those with chronic illnesses, immunosuppression, or advanced age.
  • Meningeal infections caused by S. agalactiae share clinical similarities with other bacterial meningitis.

Purpose of the Study:

  • To report a rare case of fatal invasive meningoencephalitis caused by Streptococcus agalactiae in a middle-aged adult.
  • To highlight the atypical cerebrospinal fluid (CSF) findings and rapid progression of the disease.
  • To underscore the importance of including S. agalactiae in the differential diagnosis of invasive infections in at-risk adult populations.

Main Methods:

  • Case report of a middle-aged male patient with multiple comorbidities admitted with neurological symptoms.
  • Clinical assessment including Glasgow Coma Scale, neurological examination, and vital signs.
  • Bacteriological work-up of cerebrospinal fluid (CSF), blood, and urine.
  • Autopsy to determine the cause of death and extent of organ involvement.

Main Results:

  • The patient presented with severe neurological impairment (Glasgow Coma Scale 11/12), spasticity, and hypertension.
  • S. agalactiae was isolated from CSF, blood, and urine.
  • Autopsy revealed meningoencephalitis, septic emboli, acute myocardial infarction, and pyelonephritis.
  • The patient experienced refractory shock and died within 24 hours of admission.

Conclusions:

  • Streptococcus agalactiae can cause rapidly fatal invasive meningoencephalitis in non-pregnant adults, even with atypical CSF findings.
  • Patients with underlying conditions like hypertension, diabetes, and liver cirrhosis are at increased risk.
  • Early consideration of S. agalactiae in the etiology of invasive infections in this demographic is crucial for timely diagnosis and management.
Keywords:
AutopsyBacterialMeningitisSepsisStreptococcus agalactiae

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