early-onset meningitis with group b streptococcus: the case of a female neonate with brain abscess in iran

Introduction: group b streptococcus (gbs) is a leading cause of neonatal sepsis and meningitis. although late-onset gbs meningitis is the most common form of the disease, it may happen earlier, like just a few hours after birth, known as the early-onset. gbs meningitis is associated with 30% mortality rate among infants. of those who stay alive, 25% of them will develop adverse neurological conditions. herein, we report a case of early-onset gbs meningitis in a female infant with brain abscess. case presentation: a 10-hour old female was admitted to the neonatal intensive care unit (of the university of tehran) for poor feeding, irritability, lethargy, and seizure. sepsis work-up and lumbar puncture were performed. the treatment was started with vancomycin, cefotaxime and phenobarbital. the gbs was isolated from both blood and csf cultures. a cranial sonography revealed intraparenchymal hemorrhage. the infant’s hospital course was complicated by recurrent and intractable seizures. the brain mri of the patient showed micro-abscess. after six weeks of medical therapy, the patient was discharged from the hospital in a good condition. neurological evaluations of the patient, conducted two and five months after her birth, showed normal results. conclusions: neonates with gbs meningitis are prone to adverse neurological conditions, including brain abscess. although gbs is a normal flora in the genitourinary tracts of 15 to 30% of women, routine screening and treatments of the gbs-positive women during their course of pregnancy could reduce such serious complications.