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Invasive Group B streptococcus: multiloculated perinephric abscesses treated with percutaneous drainage

J Isaac Peña-Garcia1, Sana Shaikh1, Alexandre Lacasse1

  • 1Department of Internal Medicine, SSM St. Mary's Hospital - St. Louis, St. Louis, MO, USA.

Journal of Community Hospital Internal Medicine Perspectives
|April 25, 2018
PubMed

Insights

Group B streptococcus (GBS) can cause rare perinephric abscesses (PA) in adults. This case highlights GBS as a differential diagnosis for PA, especially in immunocompromised patients.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Microbiology

Background:

  • Group B streptococcus (GBS) infections are typically seen in neonates and pregnant women.
  • Perinephric abscess (PA) is a rare manifestation of GBS infection.
  • Comorbidities like diabetes mellitus and immunosuppression increase GBS infection risk.

Observation:

  • A 61-year-old man with alcoholic cirrhosis presented with encephalopathy and abdominal pain.
  • Imaging revealed two large perinephric abscesses.
  • Abscess cultures identified beta-hemolytic Group B streptococcus.

Findings:

  • The patient developed complications including abdominal wall and paraspinal muscle spread.
  • A new diagnosis of type 2 diabetes mellitus was made.
  • Treatment involved abscess drainage and prolonged intravenous antibiotics, leading to resolution.

Implications:

  • This case underscores the importance of considering GBS in the differential diagnosis of perinephric abscesses in adults.
  • Immunosuppression and conditions like cirrhosis are risk factors for unusual GBS presentations.
  • Awareness of GBS as a pathogen for PA is crucial for timely diagnosis and management.
Keywords:
Group B streptococcusbeta-hemolytic streptococcusintra-abdominal abscesspercutaneous drainageperinephric abscessretroperitoneal abscessstreptococcus agalactiae

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