Group B Streptococcal Subscapular Abscess: A Case Report and Review of Literature

Subscapular abscesses are rare, and delayed diagnosis is common. Diagnosis is difficult as it often presents with mild symptoms like stiffness and muscular pain, mimicking other more common pathologies. Delayed diagnosis can lead to the spread of infection and increased morbidity and mortality. A high index of suspicion, prompt imaging, and early surgical drainage are keystones of management. Though all age groups are known to be affected, our case is the oldest reported patient at 83 years. He developed an abscess following a hematoma due to manipulation during physiotherapy, which subsequently got infected. Ultrasonogram and MRI demonstrated the abscess in the subscapular space. Culture and microscopy of the aspirate revealed the causative organism to be Streptococcus agalactiae, a Group B Streptococcus (GBS), which has not previously been reported as a causative organism. Invasive GBS (IGBS) in the elderly is a growing concern. We opted to drain the collection using a muscle-sparing, single-incision posterolateral approach. A literature review yielded 26 cases, which were then analyzed for age, sex, risk factors, clinical presentation, imaging, bacteriological profile, antibiotic use, and surgical approaches.