Streptococcus gallolyticus Subspecies pasteurianus Meningitis in an Infant with Hypothyroidism and Diarrhea

Streptococcus gallolyticus subspecies pasteurianus, formerly classified as S. bovis biotype II/2 until 2003, is a rare cause of infant meningitis. Over the past 2 decades, only a few individual case reports and limited case series exist in the English-language literature. Moreover, the pathogenesis of S. gallolyticus subsp. pasteurianus meningitis in infants is unclear. Here we report a case of meningitis in a 6-week-old infant with hypothyroidism and preceding diarrhea. In this case, S. gallolyticus was cultured from cerebrospinal fluid, and then S. gallolyticus subspecies pasteurianus was identified by metagenomic next-generation Sequencing. The infant recovered uneventfully after a 4-week antibiotic course with ceftriaxone and vancomycin. Then combined with the literature of S. gallolyticus subsp. pasteurianus meningitis in infants, we discuss the possible etiology.