Open AccessStreptococcus agalactiae septicemia in a patient with diabetes and hepatic cirrhosis
Author(s) -
Renan Pedroso Batista,
Cristiane Rúbia Ferreira
Publication year - 2015
Publication title -
autopsy and case reports
Language(s) - English
Resource type - Journals
ISSN - 2236-1960
DOI - 10.4322/acr.2015.028
Subject(s) - medicine , meningitis , diabetes mellitus , cirrhosis , meningoencephalitis , streptococcus agalactiae , bacteremia , coma (optics) , glasgow coma scale , gastroenterology , surgery , immunology , streptococcus , physics , optics , biology , bacteria , microbiology and biotechnology , genetics , endocrinology , antibiotics
Streptococcus agalactiae is a well-known pathogen during pregnancy and in neonates. Among non-pregnant adults, invasive infection, although rare, is showing increasing frequency, especially in chronically ill, immunosuppressed, or older patients. Although rare, the clinical features of meningeal infection caused by S. agalactiae are similar to other bacterial meningitis. The authors report the case of a middle-aged man previously diagnosed with hypertension, diabetes mellitus, and alcoholic liver cirrhosis, who was admitted at the emergency department with a Glasgow Coma Scale of 11/12, generalized spasticity, bilateral Babinski sign, and hypertension. The clinical outcome was bad, with refractory shock and death within 24 hours of hospitalization. The bacteriological work-up isolated S. agalactiae in the cerebral spinal fluid (CSF), blood, and urine. An autopsy revealed meningoencephalitis, acute myocardial infarction, and pyelonephritis due to septic emboli. The authors point out the atypical CSF findings, the rapid fatal outcome, and the importance of including this pathogen among the etiologic possibilities of invasive infections in this group of patients.