Zou D, Li F, Jiao SL, Dong JR, Xiao YY, Yan XL, Li Y, Ren D. Infantile bacterial meningitis combined with sepsis caused by Streptococcus gallolyticus subspecies pasteurianus: A case report. World J Clin Cases 2024; 12(31): 6472-6478 [DOI: 10.12998/wjcc.v12.i31.6472]
Corresponding Author of This Article
Dan Ren, MMed, Associate Chief Physician, Department of Pediatrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Jingzhong Street, Fucheng, Mianyang 621000, Sichuan Province, China. 584926501@qq.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2024; 12(31): 6472-6478 Published online Nov 6, 2024. doi: 10.12998/wjcc.v12.i31.6472
Infantile bacterial meningitis combined with sepsis caused by Streptococcus gallolyticus subspecies pasteurianus: A case report
Dan Zou, Fen Li, Shu-Li Jiao, Jin-Rong Dong, Yao-Yao Xiao, Xiao-Ling Yan, Yan Li, Dan Ren
Dan Zou, Shu-Li Jiao, Jin-Rong Dong, Yao-Yao Xiao, Xiao-Ling Yan, Yan Li, Dan Ren, Department of Pediatrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Fen Li, Department of Clinical Laboratory, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
Author contributions: Zou D wrote the manuscript and provided treatment; Li F contributed to laboratory examinations; Jiao SL, Dong JR, Xiao YY and Yan XL collaborated on the treatment; Li Y secured funding; Ren D guided the treatment and revised the manuscript.
Supported bythe Scientific Research Project from the Health Commission of Mianyang City, No. 201903.
Informed consent statement: The patient's legal guardian provided written informed consent for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dan Ren, MMed, Associate Chief Physician, Department of Pediatrics, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 12 Changjia Lane, Jingzhong Street, Fucheng, Mianyang 621000, Sichuan Province, China. 584926501@qq.com
Received: March 22, 2024 Revised: August 14, 2024 Accepted: August 21, 2024 Published online: November 6, 2024 Processing time: 172 Days and 16 Hours
Abstract
BACKGROUND
Streptococcus gallolyticus subspecies pasteurianus (SGSP) is a rare pathogen responsible for infant sepsis and meningitis and is potentially overlooked because it is not included in routine group B streptococcal screenings. Hence, we present a case of SGSP-induced infant meningitis and sepsis, accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus (MRSA), providing insights into the identification, management, and prognosis of this bacterial infection.
CASE SUMMARY
A 45-day-old female infant presented with two episodes of high fever (maximum temperature: 39.5 °C) and two generalized grand mal seizure episodes that lasted over ten seconds and self-resolved without concomitant symptoms. Postadmission, the patient’s C-reactive protein level was 40.73 mg/L, white blood cell count was 13.42 × 109/L, neutrophil ratio was 78.4%, procalcitonin level was 7.89 μg/L, cerebrospinal fluid (CSF) white cell count was 36 × 106/L, multinucleated cell ratio was 95.2%, and protein concentration was 0.41 g/L. Blood and CSF culture revealed that the pathogen was SGSP. The bacterium was sensitive to ampicillin, furazolidone, penicillin, lincomycin, moxifloxacin, rifampicin, vancomycin, and levofloxacin but resistant to clindamycin and tetracycline. Sputum culture revealed the presence of MRSA, which was sensitive to vancomycin. The patient was diagnosed with meningitis and sepsis caused by SGSP, accompanied by bronchopneumonia induced by MRSA. Ceftriaxone (100 mg/kg/d) combined with vancomycin (10 mg/kg/dose, q6h) was given as an anti-infective treatment postadmission. After 12 days of treatment, the infant was discharged from the hospital with normal CSF, blood culture, and routine blood test results, and no complications, such as subdural effusion, were observed on cranial computed tomography. No growth retardation or neurological sequelae occurred during follow-up.
CONCLUSION
SGPSP-induced infant bacterial meningitis and sepsis should be treated with prompt blood and CSF cultures, and a sensitive antibiotic therapy to ensure a favorable prognosis.
Core Tip: We present a case of infant meningitis and sepsis caused by Streptococcus gallolyticus subspecies pasteurianus (SGSP), accompanied by bronchopneumonia induced by multidrug-resistant Staphylococcus aureus. The etiological classification and drug resistance profiles of the pathogens were confirmed through timely cultures of blood, cerebrospinal fluid, and sputum. The patient was effectively treated with a combined antibiotic anti-infection regimen, had no complications or sequelae and showed normal growth and development after discharge. Since SGSP is a rare pathogen that causes bacterial meningitis in infants, with unclear mechanisms and routes of infection, this report can provide a reference for the treatment and study of similar cases.
