Group B Streptococcal Meningitis in neonates: 6 Case Reports
Case 1:
A term female newborn (39 weeks, PN 3,360 g) was born by vaginal delivery after physiologic gestation. GBS screening was performed at 35th and 37th week and resulted negative. At 4 days of life, she was admitted to the NICU for fever, feeding intolerance, poor perfusion, hypotonia, whiny crying and seizure. Immediate treatment with double anticonvulsant therapy was started. The initial blood analysis revealed increased CRP (107 mg/L) and PCT (9.85 ng/mL) and positive blood culture. Nasal and pharyngeal swabs and CSF culture were positive for GBS. Triple antibiotic (ampicillin, gentamicin and ceftazidime) treatment was started. The first cranial US (Fig. 3) was performed at 4 days of life. US revealed a markedly hyperechoic right thalamus and basal ganglia. After 2 days a second scan showed another echodensity within the caudate head (Fig. 3). Subsequently, multiple foci of cortical and subcortical hyperechogenicities were observed (Fig. 4). The last scan, performed at 2 months of life, revealed an irregular and asymmetrical ventricular enlargement with a notch of ependyma just above the left thalamus (Fig. 5). MRI (Fig. 6) demonstrated ventriculitis and bilateral basal ganglia and frontal ischemic lesions which evolved into multiple cysts in 20 days. Neurological evaluation at 1 and 4 months demonstrated normal findings....

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http://www.theijcp.org/index.php/ijcp/article/view/179/152
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