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Invasive Streptococcus agalactiae Disease With Meningitis and Septic Arthritis in a Non-pregnant Patient

Telmo Coelho1, Maria Pacheco2, Tiago Mendes3

  • 1Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT.

Cureus
|November 9, 2022
PubMed

Insights

This case report details a rare instance of Streptococcus agalactiae bacteremia causing both meningitis and septic arthritis in an immunocompetent adult. The infection originated from colic ulcers, spreading hematogenously to the central nervous system and shoulder joint.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Rheumatology

Background:

  • Streptococcus agalactiae (Group B Streptococcus) is a common human commensal.
  • Infections in immunocompetent adults are rare, with central nervous system (CNS) and septic arthritis involvement being exceptionally uncommon, especially when occurring simultaneously.

Observation:

  • A 66-year-old immunocompetent woman presented with altered mental status and fever, indicative of potential CNS infection.
  • Cerebrospinal fluid (CSF) analysis revealed pleocytosis and elevated protein levels, consistent with meningitis.
  • Subsequent development of left shoulder pain led to the identification and drainage of infectious articular fluid, confirming septic arthritis.

Findings:

  • Blood and CSF cultures isolated a susceptible strain of Streptococcus agalactiae.
  • The patient's infection was traced to colic ulcers, with subsequent hematogenous dissemination to the CNS and left shoulder joint.
  • This case represents a rare simultaneous presentation of Streptococcus agalactiae meningitis and septic arthritis.

Implications:

  • Highlights the potential for severe, disseminated Streptococcus agalactiae infections even in immunocompetent hosts.
  • Underscores the importance of considering uncommon presentations and potential sources of infection.
  • Emphasizes the need for prompt diagnosis and management of Streptococcus agalactiae bacteremia to prevent severe complications like meningitis and septic arthritis.
Keywords:
group b streptococcus agalactiae bacteremiameningitisseptic arthritisstreptococcus agalactiaestreptococcus agalactiae meningitis

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