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Group B Streptococcal Meningitis
Gary L. Hedlund, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Group B streptococcal (GBS) meningitis
          • Synonyms

            • Group B β-hemolytic streptococcal meningitis
          • Definitions

            • Leading cause of newborn meningitis in developed countries
              • Early-onset disease (EOD): GBS sepsis presenting in 1st week of life
                • 80% of GBS infections are EOD; meningitis complicates in 10%
              • Late-onset disease (LOD): GBS sepsis presenting between 1-4 weeks of life
                • 20% GBS infections are LOD; meningitis complicates in 40-60%

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Simonsen KA et al: Early-onset neonatal sepsis. Clin Microbiol Rev. 27(1):21-47, 2014
                                      2. Tan YC et al: Treatment strategies for central nervous system infections: an update. Expert Opin Pharmacother. 1-17, 2014
                                      3. Baker CJ: The spectrum of perinatal group B streptococcal disease. Vaccine. 31 Suppl 4:D3-6, 2013
                                      4. Berardi A et al: Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 131(2):e361-8, 2013
                                      5. Hernández MI et al: Stroke patterns in neonatal group B streptococcal meningitis. Pediatr Neurol. 44(4):282-8, 2011
                                      6. Thigpen MC et al: Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 364(21):2016-25, 2011
                                      7. McCourt EA et al: Isolated group B streptococcal endogenous endophthalmitis simulating retinoblastoma or persistent fetal vasculature in a healthy full-term infant. J AAPOS. 14(4):352-5, 2010
                                      8. Centers for Disease Control and Prevention (CDC): Trends in perinatal group B streptococcal disease - United States, 2000-2006. MMWR Morb Mortal Wkly Rep. 58(5):109-12, 2009
                                      9. Hamada S et al: Neonatal group B streptococcal disease: incidence, presentation, and mortality. J Matern Fetal Neonatal Med. 21(1):53-7, 2008
                                      10. Yikilmaz A et al: Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol. 38(2):129-37, 2008
                                      11. Heath PT et al: Perinatal group B streptococcal disease. Best Pract Res Clin Obstet Gynaecol. 21(3):411-24, 2007
                                      12. Smirniotopoulos JG et al: Patterns of contrast enhancement in the brain and meninges. Radiographics. 27(2):525-51, 2007
                                      13. Miyairi I et al: Group B streptococcal ventriculitis: a report of three cases and literature review. Pediatr Neurol. 34(5):395-9, 2006
                                      14. American College of Nurse-Midwives. Related Articles et al: Early-onset group B strep infection in newborns: prevention and prophylaxis Number 2, April 2003 (replaces Clinical Bulletin number 2, January 1997). J Midwifery Womens Health. 48(5):375-81, 2003
                                      15. Heath PT et al: Neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F173-8, 2003
                                      16. Stevens JP et al: Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F179-84, 2003
                                      17. Doran KS et al: Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis. J Perinatol. 22(4):326-30, 2002
                                      18. Gotoff SP: Group B streptococcal infections. Pediatr Rev. 23(11):381-6, 2002
                                      19. Barkovich AJ: Infections of the nervous system. In Pediatric Neuroimaging. Philadelphia: Lippincott William & Wilkins. 715-70, 2000
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Group B streptococcal (GBS) meningitis
                                              • Synonyms

                                                • Group B β-hemolytic streptococcal meningitis
                                              • Definitions

                                                • Leading cause of newborn meningitis in developed countries
                                                  • Early-onset disease (EOD): GBS sepsis presenting in 1st week of life
                                                    • 80% of GBS infections are EOD; meningitis complicates in 10%
                                                  • Late-onset disease (LOD): GBS sepsis presenting between 1-4 weeks of life
                                                    • 20% GBS infections are LOD; meningitis complicates in 40-60%

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Ultrasonographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Simonsen KA et al: Early-onset neonatal sepsis. Clin Microbiol Rev. 27(1):21-47, 2014
                                                                          2. Tan YC et al: Treatment strategies for central nervous system infections: an update. Expert Opin Pharmacother. 1-17, 2014
                                                                          3. Baker CJ: The spectrum of perinatal group B streptococcal disease. Vaccine. 31 Suppl 4:D3-6, 2013
                                                                          4. Berardi A et al: Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 131(2):e361-8, 2013
                                                                          5. Hernández MI et al: Stroke patterns in neonatal group B streptococcal meningitis. Pediatr Neurol. 44(4):282-8, 2011
                                                                          6. Thigpen MC et al: Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 364(21):2016-25, 2011
                                                                          7. McCourt EA et al: Isolated group B streptococcal endogenous endophthalmitis simulating retinoblastoma or persistent fetal vasculature in a healthy full-term infant. J AAPOS. 14(4):352-5, 2010
                                                                          8. Centers for Disease Control and Prevention (CDC): Trends in perinatal group B streptococcal disease - United States, 2000-2006. MMWR Morb Mortal Wkly Rep. 58(5):109-12, 2009
                                                                          9. Hamada S et al: Neonatal group B streptococcal disease: incidence, presentation, and mortality. J Matern Fetal Neonatal Med. 21(1):53-7, 2008
                                                                          10. Yikilmaz A et al: Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol. 38(2):129-37, 2008
                                                                          11. Heath PT et al: Perinatal group B streptococcal disease. Best Pract Res Clin Obstet Gynaecol. 21(3):411-24, 2007
                                                                          12. Smirniotopoulos JG et al: Patterns of contrast enhancement in the brain and meninges. Radiographics. 27(2):525-51, 2007
                                                                          13. Miyairi I et al: Group B streptococcal ventriculitis: a report of three cases and literature review. Pediatr Neurol. 34(5):395-9, 2006
                                                                          14. American College of Nurse-Midwives. Related Articles et al: Early-onset group B strep infection in newborns: prevention and prophylaxis Number 2, April 2003 (replaces Clinical Bulletin number 2, January 1997). J Midwifery Womens Health. 48(5):375-81, 2003
                                                                          15. Heath PT et al: Neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F173-8, 2003
                                                                          16. Stevens JP et al: Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F179-84, 2003
                                                                          17. Doran KS et al: Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis. J Perinatol. 22(4):326-30, 2002
                                                                          18. Gotoff SP: Group B streptococcal infections. Pediatr Rev. 23(11):381-6, 2002
                                                                          19. Barkovich AJ: Infections of the nervous system. In Pediatric Neuroimaging. Philadelphia: Lippincott William & Wilkins. 715-70, 2000