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Group B streptococcal meningitis in adults
1Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut 06510.
Abstract:
Group B streptococcal (GBS) meningitis is a frequent entity in neonates but an uncommon cause of meningitis in adults. Retrospective analysis at our institution identified 4 adult cases over the last 25 years; an additional 46 cases from the literature were reviewed. A bimodal age distribution paralleling that seen in other severe GBS infections was observed. Clinical presentation was not unlike meningitis due to other pyogenic organisms, although a higher percentage of patients presented with less than 24 hours of symptoms. Forty-three percent of patients had no underlying illnesses. Concomitant bacteremia was present in 83% of patients. The overall mortality was 27% and was limited exclusively to patients with co-morbid illnesses. Meningitis in adults due to GBS should be considered in the immunocompetent as well as the immunocompromised host.
Insights
Group B streptococcal meningitis is rare in adults but can occur in both healthy and immunocompromised individuals. Mortality is high, particularly in those with co-existing health conditions.
Area of Science:
- Infectious Diseases
- Neurology
- Bacteriology
Background:
- Group B streptococcal (GBS) meningitis is a common neonatal infection but infrequently observed in adults.
- This study reviews adult GBS meningitis cases to understand its epidemiology and clinical characteristics.
Observation:
- A retrospective analysis identified 4 adult cases over 25 years, supplemented by 46 literature cases.
- Bimodal age distribution noted, similar to other severe GBS infections.
- Clinical presentation often mimics other pyogenic meningitis, with a significant proportion of patients experiencing rapid symptom onset (<24 hours).
Findings:
- 43% of adult GBS meningitis patients had no underlying illnesses.
- Concomitant bacteremia was present in 83% of cases.
- The overall mortality rate was 27%, exclusively among patients with co-morbidities.
Implications:
- Adult GBS meningitis should be considered in both immunocompetent and immunocompromised patients.
- Highlights the potential severity of GBS infections beyond the neonatal period.
- Emphasizes the need for prompt diagnosis and management in suspected adult GBS meningitis cases.