Streptococcus Agalactiae Meningitis Presented with Cerebral Infarction in Adult Patient - Clinical Case and Review

Neurol India. 2022 Sep-Oct;70(5):2145-2148. doi: 10.4103/0028-3886.359190.


Background: Bacterial meningitis (BM) is an inflammation of the meninges, associated with the invasion of bacteria. The etiologic agents vary by age group. BM because of Group B streptococcus (GBS) is common for the neonatal period but considered as rare in adult patients. Acute BM can have various presentations and adverse effects, such as ischemic stroke in 10% to 29% of the cases.

Objective: This study aimed to present a rare case of GBS meningitis presented with cerebral infarction (CI) in an adult patient and to make a brief review of the etiology and incidence of GBS infections in adults.

Case report: We present a case of a 62-year-old female who presented with acute onset of central lesion of the right facial nerve, mild hemiparesis on the right, and partial sensorimotor aphasia. There were no signs of meningoradicular irritation. The pupils were equal, with slow reaction to light, and unaffected eye movements. There was a central lesion of the right facial nerve and mild hemiparesis on the right. Tendon reflexes were unremarkable and Babinski's sign was negative bilaterally.

Discussion: This review shows an increasing incidence of cases in elderly patients. A higher risk of GBS is found in adults with more medical comorbidities. CI, as a rare adverse effect in BM, is both a sign for severity and a predictor of a poor clinical outcome with a high lethal rate. GBS infections are a growing problem in older adults and those with chronic medical conditions. The involvement of the central nervous system as meningitis is a less common manifestation with a high lethal rate.

Conclusions: CI is a rare adverse effect of neuro infections leading to an even worse clinical outcome. Early recognition of the infection and appropriate antimicrobial therapy are the crucial moments of successful management of GBS disease.

Keywords: Cerebral infarction; Group B Streptococcus; Ischemic Stroke; Streptococcus agalactiae; Stroke; meningitis; neuro infections.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Cerebral Infarction / etiology
  • Female
  • Humans
  • Infant, Newborn
  • Meningitis, Bacterial* / complications
  • Meningitis, Bacterial* / diagnosis
  • Meningitis, Bacterial* / drug therapy
  • Middle Aged
  • Paresis
  • Streptococcal Infections* / complications
  • Streptococcal Infections* / diagnosis
  • Streptococcus agalactiae