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Group B Streptococcal Meningitis
Surjith Vattoth, MD, FRCR; Gary L. Hedlund, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • 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. Buurman ET et al: A novel hexavalent capsular polysaccharide conjugate vaccine (GBS6) for the prevention of neonatal group B streptococcal infections by maternal immunization. J Infect Dis. 220(1):105-15, 2019
                                          2. Martis JMS et al: Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates. Acta Paediatr. 108(5):855-64, 2019
                                          3. Choi SY et al: Patterns of ischemic injury on brain images in neonatal group B Streptococcal meningitis. Korean J Pediatr. 61(8):245-52, 2018
                                          4. Simonsen KA et al: Early-onset neonatal sepsis. Clin Microbiol Rev. 27(1):21-47, 2014
                                          5. Tan YC et al: Treatment strategies for central nervous system infections: an update. Expert Opin Pharmacother. 1-17, 2014
                                          6. Baker CJ: The spectrum of perinatal group B streptococcal disease. Vaccine. 31 Suppl 4:D3-6, 2013
                                          7. Berardi A et al: Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 131(2):e361-8, 2013
                                          8. Hernández MI et al: Stroke patterns in neonatal group B streptococcal meningitis. Pediatr Neurol. 44(4):282-8, 2011
                                          9. Thigpen MC et al: Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 364(21):2016-25, 2011
                                          10. 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
                                          11. 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
                                          12. Hamada S et al: Neonatal group B streptococcal disease: incidence, presentation, and mortality. J Matern Fetal Neonatal Med. 21(1):53-7, 2008
                                          13. Yikilmaz A et al: Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol. 38(2):129-37, 2008
                                          14. Heath PT et al: Perinatal group B streptococcal disease. Best Pract Res Clin Obstet Gynaecol. 21(3):411-24, 2007
                                          15. Smirniotopoulos JG et al: Patterns of contrast enhancement in the brain and meninges. Radiographics. 27(2):525-51, 2007
                                          16. Miyairi I et al: Group B streptococcal ventriculitis: a report of three cases and literature review. Pediatr Neurol. 34(5):395-9, 2006
                                          17. 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
                                          18. Heath PT et al: Neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F173-8, 2003
                                          19. Stevens JP et al: Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F179-84, 2003
                                          20. Doran KS et al: Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis. J Perinatol. 22(4):326-30, 2002
                                          21. Gotoff SP: Group B streptococcal infections. Pediatr Rev. 23(11):381-6, 2002
                                          22. 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

                                                • Pathology

                                                  • Clinical Issues

                                                    • 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. Buurman ET et al: A novel hexavalent capsular polysaccharide conjugate vaccine (GBS6) for the prevention of neonatal group B streptococcal infections by maternal immunization. J Infect Dis. 220(1):105-15, 2019
                                                                                  2. Martis JMS et al: Brain imaging can predict neurodevelopmental outcome of Group B streptococcal meningitis in neonates. Acta Paediatr. 108(5):855-64, 2019
                                                                                  3. Choi SY et al: Patterns of ischemic injury on brain images in neonatal group B Streptococcal meningitis. Korean J Pediatr. 61(8):245-52, 2018
                                                                                  4. Simonsen KA et al: Early-onset neonatal sepsis. Clin Microbiol Rev. 27(1):21-47, 2014
                                                                                  5. Tan YC et al: Treatment strategies for central nervous system infections: an update. Expert Opin Pharmacother. 1-17, 2014
                                                                                  6. Baker CJ: The spectrum of perinatal group B streptococcal disease. Vaccine. 31 Suppl 4:D3-6, 2013
                                                                                  7. Berardi A et al: Group B streptococcus late-onset disease: 2003-2010. Pediatrics. 131(2):e361-8, 2013
                                                                                  8. Hernández MI et al: Stroke patterns in neonatal group B streptococcal meningitis. Pediatr Neurol. 44(4):282-8, 2011
                                                                                  9. Thigpen MC et al: Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 364(21):2016-25, 2011
                                                                                  10. 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
                                                                                  11. 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
                                                                                  12. Hamada S et al: Neonatal group B streptococcal disease: incidence, presentation, and mortality. J Matern Fetal Neonatal Med. 21(1):53-7, 2008
                                                                                  13. Yikilmaz A et al: Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol. 38(2):129-37, 2008
                                                                                  14. Heath PT et al: Perinatal group B streptococcal disease. Best Pract Res Clin Obstet Gynaecol. 21(3):411-24, 2007
                                                                                  15. Smirniotopoulos JG et al: Patterns of contrast enhancement in the brain and meninges. Radiographics. 27(2):525-51, 2007
                                                                                  16. Miyairi I et al: Group B streptococcal ventriculitis: a report of three cases and literature review. Pediatr Neurol. 34(5):395-9, 2006
                                                                                  17. 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
                                                                                  18. Heath PT et al: Neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F173-8, 2003
                                                                                  19. Stevens JP et al: Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed. 88(3):F179-84, 2003
                                                                                  20. Doran KS et al: Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis. J Perinatol. 22(4):326-30, 2002
                                                                                  21. Gotoff SP: Group B streptococcal infections. Pediatr Rev. 23(11):381-6, 2002
                                                                                  22. Barkovich AJ: Infections of the nervous system. In Pediatric Neuroimaging. Philadelphia: Lippincott William & Wilkins. 715-70, 2000