Cerebral abscess caused by Streptococcus agalactiae, an unusual presentation

Abstract

During the first three months of life, Group B streptococcus or Agalactiae (GBS) can cause meningitis and be associated with cerebrovascular accidents resulting from sepsis and infection of the central nervous system. This article presents the unusual case of a female infant who was afflicted with GBS, meningitis, sepsis complicated by septic shock, ischemic lesions secondary to inflammatory vasculitis and a cerebral abscess accompanied by epileptic seizures with a hypsarrythmia electroencephalographic pattern. A long-term NICU stay with antibiotic management, inotropic support and antiepileptic treatment succeeded in resolving the acute stage of the illness. Out-patient follow-up revealed increased muscle-tone, but delayed neurological development. While this improved significantly with integral rehabilitative therapy, a slight delay still remained. Neuroimaging follow-up at 18 months found malacia-area and core retractions in the left caudate nucleus.